耐顺铂相关基因MDR1、MRP、LRP及GST-π在非小细胞肺癌中的表达及与生存相关的Meta分析

摘要

目的:采用循证医学系统分析方法了解肿瘤耐顺铂相关基因与非小细胞肺癌的相关性,为科学制定化疗方案提供理论依据.方法:检索中国学术期刊网(CNKI)全文数据库、维普科技期刊、美国国立图书馆PUBMED;检索时间段为1979 - 2011年；获得符合纳入标准的关于非小细胞肺癌耐药相关基因MDR1、MRP、LRP及GST -π的文献研究27篇；采用Stata11.0进行统计分析.结果:非小细胞肺癌组织与正常肺组织耐药基因表达合并效应显示,非小细胞肺癌组织耐顺铂相关基因表达水平明显高于正常肺组织.4种基因合并OR值并计算95％可信区间,各基因表达结果按照OR值大小顺序,OR值及95％可信区间依次为GST -π30.86(16.03,59.40)、LRP 13.96(9.27,21.01)、MRP 12.69(8.36,19.26)、MDR1 8.03 (4.45,14.48),其中LRP及MRP基因3年死亡人数明显高于3年生存人数,OR值及95％可信区间分别为LRP 4.75(2.11,10.67)、MRP 4.61(2.28,9.32).结论:耐顺铂相关基因MRP、LRP、GST -π及MDR1在非小细胞肺癌组织中呈高表达,尤以GST -π基因为著,其余依次是LRP、MRP、MDR1基因.各基因在非小细胞肺癌组织中表达的高低直接影响化疗效果和预后,是非小细胞肺癌化疗耐药中的重要基因.%Objective: To understand the relationship between cisplatin resistance genes and non - small — cell lung cancerbase on system analysis method of evidence — based medicine and provide a theoretical basis for programming chemotherapy. Methods:Searching in CNKI,VAP and PUBMED( 1979 -2011 ) , to obtain 27 studies on drug resistance gene MDR1, MRP, LRP, GST - πand non - small - cell lung cancer. All data were analyzed by Statal 1. 0 special software. Results: Expression level of cisplatin resistance gene was obviously higher in non — small - cell lung cancer tissue than that in normal lung tissue. According to 95% confidence interval of combined OR value , the sequence of OR values was GST - tt 30. 86( 16. 03,59. 40) , LRP 13. 96(9. 27,21. 01) , MRP 12. 69(8. 36,19. 26) , MDR1 8. 03 (4. 45 ,14. 48). The number of 3 - year deaths was significantly higher than that of 3 - year survival in LRP and M RP genes , OR value and 95 % confidence interval were LRP 4. 75 (2. 11 ,10. 67 ) , MRP 4. 61 ( 2. 28 , 9.32). Conclusion:Cisplatin resistance genes MDR1 ,MRP,LRP and GST - tt were highly expressed in non -small - cell lung cancer tissue, particularly GST - tt gene, and LRP gene, MRP gene, MDR1 gene were in degressive order. The level of every gene in non - small - cell lung cancer tissue directly has an influence on the effect of chemotherapy and prognosis. All of 4 genes are highly important for chemotherapy of non - small — cell lung cancer.