MiRNA-21的表达与结直肠癌患者术后预后关系的meta分析
发布时间：2018-07-28 13:44
【摘要】：目的:结直肠癌是常见的消化道恶性肿瘤之一,其预后受多方面的影响,miRNA-21在结直肠癌患者预后中的影响仍存在争议,本研究主要采用循证医学的方法通过对miRNA-21与结直肠癌患者预后之间的关系进行meta分析,为临床诊疗提供循证医学证据。方法:按照本研究的类型、研究对象和研究目的等制定严格的文献纳入与排除标准、详细的检索策略,通过计算机系统检索了PubMed、EBSCO、EMBASE全文数据库、Cochrane图书馆、Medline、中国学术期刊全文数据库(CNKI)、万方数据库、科学引文索引数据库、中国生物医学文献数据库、重庆维普中文科技期刊数据库等数据库。检索自该数据库建立时间至2017年03月公开发表的相关文献,为了提高查全率,我们又对所有相关参考文献进行了追踪。纳入的相关研究文献经过纽卡斯尔-渥太华量表(The Newcastle-Ottawa Scale,NOS)行质量评价后,建立Excel表格收集相关数据,采用国际Cochrane协作网提供的Revman5.3软件和Stata12.0软件对所提取的数据资料进行统计学分析处理,生存分析的效应量通常采用危险比(HR),各检验效应量水准采用95%可信区间(confidence interval,CI)表示。绘制结果森林图和漏斗图并采用Egger线性回归法和Begg秩相关检验法定量分析发表偏倚来验证是否有发表偏倚,假若漏斗图不对称和(或)Egger线性回归法中的P0.1时,表明可能存在发表偏倚。结果:最终纳入18篇文献共4394名结直肠癌癌患者,其中15篇文献涉及的是组织中miRNA-21与结直肠癌预后关系,3篇将血液中miRNA-21作为样本来研究;有7篇文献提供了miRNA-21与DFS之间的关系,13篇文献给出了miRNA-21与OS之间的关系。此外,Oue和Schetter分别报道了两组独立样本中miRNA-21与OS之间的关系。Meta分析研究结果显示1、在10项涉及结直肠癌患者组织中miRNA-21的表达与OS之间关系的研究中,合并后的效应量HR=2.57,95%CI为(2.11,3.14),P0.00001,差异有统计学意义。95%CI不包含1,且合并HR1,提示结直肠癌患者组织中过表达的miRNA-21与术后不良的总生存期有显著相关性,其术后具有较短总生存期的危险是miRNA-21无过表达患者的2.57倍,说明组织中miRNA-21过表达的结直肠癌患者预后欠佳,miRNA-21是结直肠癌患者预后的不良因素;2、在分析结直肠癌患者组织中miRNA-21的表达与DFS之间的关系时,共纳入7项研究,合并后的效应量HR=1.49,95%CI为(1.33,1.68),P0.00001。95%CI不包含1,且合并HR1,提示组织中miRNA-21过表达的结直肠癌患者具有较短的无病生存期,其术后具有较短无病生存期的危险是miRNA-21无过表达患者的1.49倍,说明miRNA-21是结直肠癌患者预后的不良因素;3、此次仅有3项研究涉及了结直肠癌患者血液中miRNA-21的表达与其预后之间的关系,该3项研究报道均与OS有关,且异质性较大,采取随机效应模型,合并后的效应量HR=1.33,95%CI值为(0.44,4.02),P=0.61,差异无统计学意义。提示在结直肠癌患者的血液中过表达的miRNA-21与其术后总的生存期无明显相关性,即在血液中miRNA-21呈过表达水平的结直肠癌患者中,其术后总的生存期并不一定短。结论:1、结直肠癌患者的预后受多种因素的影响,其中miRNA-21的过表达提示结直肠癌预后不良;2、miRNA-21可作为未来结直肠癌治疗研究的一个新方向,为结直肠癌的靶向治疗提供了一个潜在靶点;3、本研究不能完全避免偏倚的存在,尚需更多高质量临床研究来进一步验证该研究结果。
[Abstract]:Objective: colorectal cancer is one of the common malignant tumor of the digestive tract, and its prognosis is affected by many factors. The influence of miRNA-21 in the prognosis of colorectal cancer patients is still controversial. This study mainly uses evidence-based medicine to provide evidence for clinical diagnosis and treatment by meta analysis of the relationship between miRNA-21 and the prognosis of colorectal cancer patients. Medical evidence. Methods: according to the type of the research, the object of research and the purpose of the study, the strict document inclusion and exclusion criteria, the detailed retrieval strategy, the PubMed, EBSCO, EMBASE full text database, the Cochrane library, Medline, the full text database of Chinese academic periodicals (CNKI), the Wanfang database and the scientific citation were retrieved through computer system. The index database, the Chinese biomedical literature database, the database of the Chongqing VIP Chinese sci-tech journal, and other databases were retrieved from the date of the establishment of the database to 03 months of 2017. In order to improve the recall, all the related references were traced. The relevant literature included in Newcastle - After the quality evaluation of the The Newcastle-Ottawa Scale (NOS), we set up the Excel form to collect the relevant data, and use the Revman5.3 software and Stata12.0 software provided by the international Cochrane cooperation network to analyze the extracted data, and the effect of survival analysis usually uses the risk ratio (HR), each test effect amount of water is water. The 95% confidence interval (confidence interval, CI) is used. The result forest map and the funnel plot are drawn and the Egger linear regression method and the Begg rank correlation test are used to quantify the publication bias to verify whether there is a publication bias. If the funnel map asymmetry and (or) the (or) Egger linear regression method are P0.1, there may be a publication bias. Result: in the final 18 literature, 4394 patients with colorectal cancer were included, 15 of which were related to the relationship between miRNA-21 and the prognosis of colorectal cancer, and 3 were used to study the miRNA-21 in the blood; 7 documents provided the relationship between miRNA-21 and DFS, and 13 articles presented the relationship between miRNA-21 and OS. In addition, Oue and Schett Er reported the relationship between miRNA-21 and OS in two groups of independent samples. The results of.Meta analysis showed 1. In the study of the relationship between the expression of miRNA-21 and OS in the 10 colorectal cancer patients, the combined effect HR=2.57,95%CI was (2.11,3.14), P0.00001, the difference was statistically significant and.95%CI did not contain 1, and HR1, It is suggested that the overexpressed miRNA-21 in the tissues of the colorectal cancer patients has a significant correlation with the poor total survival period. The risk of short total survival after the operation is 2.57 times as high as that of the patients without overexpression of miRNA-21. It indicates that the prognosis of colorectal cancer patients with miRNA-21 overexpression in the tissue is poor and miRNA-21 is a bad cause of the prognosis of colorectal cancer patients. 2, in the analysis of the relationship between miRNA-21 expression and DFS in colorectal cancer patients, 7 studies were included. The combined effect of HR=1.49,95%CI was (1.33,1.68), P0.00001.95%CI did not contain 1, and HR1 was combined, suggesting that colorectal cancer patients with miRNA-21 overexpression in the tissue have a shorter disease-free survival and a shorter postoperative period. The risk of the disease was 1.49 times the risk of miRNA-21 without overexpression, indicating that miRNA-21 was an adverse factor in the prognosis of colorectal cancer patients. 3, only 3 studies involved the relationship between the expression of miRNA-21 in the blood of the rectal cancer patients and the prognosis of the prognosis. The 3 studies were all related to OS, and the heterogeneity was larger and took a random Xiao Yingmo. The HR=1.33,95%CI value of the combined effect was (0.44,4.02) and P=0.61, the difference was not statistically significant. It suggested that the overexpressed miRNA-21 in the blood of the patients with colorectal cancer had no significant correlation with the total survival, that is, the total survival of the patients with colorectal cancer in the blood of miRNA-21 in the blood was not necessarily short. Conclusions: 1, the prognosis of colorectal cancer patients is affected by many factors, and the overexpression of miRNA-21 suggests poor prognosis for colorectal cancer; 2, miRNA-21 can be a new direction for the future research of colorectal cancer, and provide a potential target for the targeted treatment of colorectal cancer; 3, this study can not completely avoid the existence of bias and still need more. High quality clinical studies are needed to further validate the findings.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34
本文编号：2150332
[Abstract]:Objective: colorectal cancer is one of the common malignant tumor of the digestive tract, and its prognosis is affected by many factors. The influence of miRNA-21 in the prognosis of colorectal cancer patients is still controversial. This study mainly uses evidence-based medicine to provide evidence for clinical diagnosis and treatment by meta analysis of the relationship between miRNA-21 and the prognosis of colorectal cancer patients. Medical evidence. Methods: according to the type of the research, the object of research and the purpose of the study, the strict document inclusion and exclusion criteria, the detailed retrieval strategy, the PubMed, EBSCO, EMBASE full text database, the Cochrane library, Medline, the full text database of Chinese academic periodicals (CNKI), the Wanfang database and the scientific citation were retrieved through computer system. The index database, the Chinese biomedical literature database, the database of the Chongqing VIP Chinese sci-tech journal, and other databases were retrieved from the date of the establishment of the database to 03 months of 2017. In order to improve the recall, all the related references were traced. The relevant literature included in Newcastle - After the quality evaluation of the The Newcastle-Ottawa Scale (NOS), we set up the Excel form to collect the relevant data, and use the Revman5.3 software and Stata12.0 software provided by the international Cochrane cooperation network to analyze the extracted data, and the effect of survival analysis usually uses the risk ratio (HR), each test effect amount of water is water. The 95% confidence interval (confidence interval, CI) is used. The result forest map and the funnel plot are drawn and the Egger linear regression method and the Begg rank correlation test are used to quantify the publication bias to verify whether there is a publication bias. If the funnel map asymmetry and (or) the (or) Egger linear regression method are P0.1, there may be a publication bias. Result: in the final 18 literature, 4394 patients with colorectal cancer were included, 15 of which were related to the relationship between miRNA-21 and the prognosis of colorectal cancer, and 3 were used to study the miRNA-21 in the blood; 7 documents provided the relationship between miRNA-21 and DFS, and 13 articles presented the relationship between miRNA-21 and OS. In addition, Oue and Schett Er reported the relationship between miRNA-21 and OS in two groups of independent samples. The results of.Meta analysis showed 1. In the study of the relationship between the expression of miRNA-21 and OS in the 10 colorectal cancer patients, the combined effect HR=2.57,95%CI was (2.11,3.14), P0.00001, the difference was statistically significant and.95%CI did not contain 1, and HR1, It is suggested that the overexpressed miRNA-21 in the tissues of the colorectal cancer patients has a significant correlation with the poor total survival period. The risk of short total survival after the operation is 2.57 times as high as that of the patients without overexpression of miRNA-21. It indicates that the prognosis of colorectal cancer patients with miRNA-21 overexpression in the tissue is poor and miRNA-21 is a bad cause of the prognosis of colorectal cancer patients. 2, in the analysis of the relationship between miRNA-21 expression and DFS in colorectal cancer patients, 7 studies were included. The combined effect of HR=1.49,95%CI was (1.33,1.68), P0.00001.95%CI did not contain 1, and HR1 was combined, suggesting that colorectal cancer patients with miRNA-21 overexpression in the tissue have a shorter disease-free survival and a shorter postoperative period. The risk of the disease was 1.49 times the risk of miRNA-21 without overexpression, indicating that miRNA-21 was an adverse factor in the prognosis of colorectal cancer patients. 3, only 3 studies involved the relationship between the expression of miRNA-21 in the blood of the rectal cancer patients and the prognosis of the prognosis. The 3 studies were all related to OS, and the heterogeneity was larger and took a random Xiao Yingmo. The HR=1.33,95%CI value of the combined effect was (0.44,4.02) and P=0.61, the difference was not statistically significant. It suggested that the overexpressed miRNA-21 in the blood of the patients with colorectal cancer had no significant correlation with the total survival, that is, the total survival of the patients with colorectal cancer in the blood of miRNA-21 in the blood was not necessarily short. Conclusions: 1, the prognosis of colorectal cancer patients is affected by many factors, and the overexpression of miRNA-21 suggests poor prognosis for colorectal cancer; 2, miRNA-21 can be a new direction for the future research of colorectal cancer, and provide a potential target for the targeted treatment of colorectal cancer; 3, this study can not completely avoid the existence of bias and still need more. High quality clinical studies are needed to further validate the findings.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34
【参考文献】
相关期刊论文 前7条
1 Wei-Zhong Sheng;Yu-Sheng Chen;Chuan-Tao Tu;Juan He;Bo Zhang;Wei-Dong Gao;;Micro RNA-21 promotes phosphatase gene and protein kinase B/phosphatidylinositol 3-kinase expression in colorectal cancer[J];World Journal of Gastroenterology;2016年24期
2 Shuzheng Liu;Rongshou Zheng;Meng Zhang;Siwei Zhang;Xibin Sun;Wanqing Chen;;Incidence and mortality of colorectal cancer in China, 2011[J];Chinese Journal of Cancer Research;2015年01期
3 胡小苗;李明忠;;大肠癌组织中miRNA-21表达水平及其与预后的研究[J];中国普通外科杂志;2014年12期
4 Shailender Singh Kanwar;Anuradha Poolla;Adhip PN Majumdar;;Regulation of colon cancer recurrence and development of therapeutic strategies[J];World Journal of Gastrointestinal Pathophysiology;2012年01期
5 Lindsey E.Becker Buscaglia;;Apoptosis and the target genes of microRNA-21[J];癌症;2011年06期
6 石修权;王增珍;;Meta回归与亚组分析在异质性处理中的应用[J];中华流行病学杂志;2008年05期
7 蔡毅;邢岩;胡丹;;敏感性分析综述[J];北京师范大学学报(自然科学版);2008年01期
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