ERCC1基因多态性与非小细胞肺癌患者铂类化疗疗效相关性的Meta分析

摘要/Abstract

摘要： 目的：系统评价切除修复交叉互补基因1（ERCC1）基因多态性与非小细胞肺癌（NSCLC）患者铂类化疗疗效之间的相关性，确定ERCC1基因多态性是否能作为NSCLC患者铂类化疗疗效的预测指标，并把循证医学与精准化药物治疗方案有机结合，为铂类药物临床用药剂量的调整提供依据，以提高化疗方案的有效率。方法：系统检索涉及ERCC1基因多态性与NSCLC患者铂类化疗疗效相关性的研究，检索的数据库包括英文数据库：PubMed、Embase、Cochrane Library；中文数据库：CBM、CNKI、WANFANG、VIP。建立严格的文献纳入和排除标准，筛选出高质量的队列研究进行Meta分析，分析的结局指标为客观缓解率（ORR），通过计算合并比值比（OR）和95%置信区间（CI）来评估单核苷酸多态性（SNPs）与ORR之间的联系，所有分析均使用Review Manager 5.3进行。结果：共18篇相关研究，2 380名NSCLC患者被纳入到本次Meta分析中。根据本次研究的结果，并没有发现ERCC1基因多态性与NSCLC患者铂类化疗疗效之间存在相关性的统计学证据。ERCC1 C118T：显性模型（CT+TT vs CC：OR=0.95，95%CI=0.68~1.34，P=0.78），共显性模型（CT vs CC：OR=0.77，95%CI=0.57~1.03，P=0.08；TT vs CC：OR=1.00，95%CI=0.49~2.05，P=0.99）。ERCC1 C8092A：显性模型（CA+AA vs CC：OR=1.00，95%CI=0.79~1.27，P=0.98），共显性模型（CA vs CC：OR=0.85，95%CI=0.56~1.29，P=0.44；AA vs CC：OR=0.54，95%CI=0.09~3.36，P=0.51）。结论：本次Meta分析没有发现ERCC1基因多态性与NSCLC患者铂类化疗疗效之间存在相关性，研究证据尚不足以证明ERCC1基因多态性可预测NSCLC患者铂类化疗的疗效。但是鉴于本次Meta分析的局限性和异质性，所得结论需要谨慎解读，未来需要更大规模的前瞻性研究与更严格的研究设计予以验证。

Abstract: Objective：The relationship between Excision Repair Cross-Complementation Group 1(ERCC1) gene polymorphisms and the efficacy of platinum-based chemotherapy in non-small cell lung cancer (NSCLC) patients was systematically evaluated to determine whether ERCC1 gene polymorphisms could be used as a predictor of the efficacy of platinum-based chemotherapy in NSCLC patients. And the organic combination of evidence based medicine and precision drug treatment regimen， to provide a basis for the adjustment of the clinical dose of platinum drugs， in order to improve the efficiency of chemotherapy regimens.Methods： All studies involving the association of the ERCC1 gene polymorphisms with the efficacy of platinum-based chemotherapy in NSCLC patients were systematically searched， including English database： PubMed， Embase， Cochrane Library； Chinese database： CBM， CNKI， WANFANG， VIP. Establish strict inclusion and exclusion criteria for the literatures， screen high-quality cohort studies for Meta-analysis. The outcome of the analysis is objective response rate (ORR). The association between single nucleotide polymorphisms (SNPs) and ORR was assessed by calculating the odds ratio (OR) and the 95% confidence interval (CI). All analyzes were performed using the Review Manager version 5.3.Results： A total of 18 related studies， 2380 NSCLC patients were included in this Meta-analysis. According to the results of this study， there was no statistical evidence of a association between the ERCC1 gene polymorphisms and the efficacy of platinum-based chemotherapy in NSCLC patients. ERCC1 C118T： dominant model (CT + TT vs CC： OR=0.95， 95% CI=0.68-1.34，P=0.78)， and the codominant model (CT vs CC： OR=0.77， 95% CI=0.57-1.03，P=0.08； TT vs CC： OR=1.00， 95% CI=0.49-2.05，P=0.99). ERCC1 C8092A： dominant model (CA + AA vs CC： OR=1.00， 95% CI=0.79-1.27，P=0.98)， and the codominant model (CA vs CC： OR=0.85， 95% CI=0.56-1.29，P=0.44； AA vs CC： OR=0.54， 95% CI=0.09-3.36，P=0.51).Conclusion： This Meta-analysis found no association between ERCC1 gene polymorphisms and the efficacy of platinum-based chemotherapy in NSCLC patients. The research evidence is not sufficient to prove that ERCC1 gene polymorphisms can predict the efficacy of platinum-based chemotherapy in NSCLC patients. However， given the limitations and heterogeneity of this Meta-analysis， the conclusions need to be interpreted cautiously. The future requires larger prospective studies and more rigorous research designs to test these conclusions.

张凌雄,张阳,宋沧桑,杨琨琨. ERCC1基因多态性与非小细胞肺癌患者铂类化疗疗效相关性的Meta分析[J]. .

zhanglingxiong,, and. A Meta-analysis of the Association Between ERCC1 Gene Polymorphisms and the Efficacy of Platinum-based Chemotherapy in Non-small Cell Lung Cancer Patients[J]. .

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