术前血清癌胚抗原质量浓度对非小细胞肺癌患者预后作用的 Meta 分析

摘要

Objective To explore the prognostic role of preoperative serum carcinoembryonic antigen(CEA) levels in non-small cell lung cancer(NSCLC) patients. Methods Electronic databases updated to June 1, 2014 were searched to find relevant studies. A meta-analysis was made with eligible studies which quantitatively evaluated the relationship between preoperative serum CEA level and survival of patients with NSCLC. Survival data were aggregated and quantitatively analyzed. Results Totally 16 studies(n=4 296 patients) were enrolled. We evaluated the correlation between preoperative serum CEA level and survival in patients with NSCLC. Combined hazard ratios suggested that preoperative serum CEA overexpression was associated with poor prognosis of overall survival(OS)(HR=2. 28, 95%CI: 2. 24-2. 31) in patients. Meanwhile, for p-stage I NSCLC, the HR(95% CI) was 1. 98(1. 73-2. 15). In the stratified analysis by patient source, significant risks were found among Asians and non-Asians. However, significant heterogeneity was observed among all studies. Conclusion In the present meta-analysis, preoperative serum CEA overexpression indicated a poor prognosis for patients with NSCLC.%目的：分析术前血清癌胚抗原(carcinoembryonic antigen,CEA)质量浓度对非小细胞肺癌(non-small cell lung cancer, NSCLC)的预后价值。方法检索截至2014年6月1日数据库相关研究文献,针对术前血清 CEA 质量浓度与 NSCLC 患者生存关系进行定量评估并符合条件的文献行 meta 分析,汇总生存数据并行定量分析。结果共有16个研究(n =4296)评估 NSCLC患者中术前 CEA 质量浓度与患者的生存。组合风险比(hazard ratio,HR)提示 NSCLC 患者中,术前血清 CEA 过表达与总生存期不良预后相关(HR=2.28,95% CI：2.2~2.31)。同时对于病理分期为Ⅰ期的 NSCLC 患者,风险比是1.98(95% CI：1.73~2.15)。患者资料进行分层分析后结果显示亚洲和非亚洲患者中显著风险相关。然而,在所有研究中发现存在显著的异质性。结论术前血清 CEA 的高表达提示 NSCLC 患者预后不良。