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目的系统评价缺氧诱导因子-1α(HIF-1α)蛋白表达与肾细胞癌及其不同临床病理特征的相关性。方法计算机检索The Cochrane Library、Pub Med、EMbase、CNKI、VIP、CBM和Wan Fang Data,搜集国内外公开发表关于HIF-1α蛋白表达与肾细胞癌及其不同临床病理特征相关性的病例-对照研究,检索时限均为从建库至2015年6月。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入8个病例-对照研究,包括肾细胞癌组429例,正常肾组织组130例。Meta分析结果显示:HIF-1α蛋白在肾细胞癌组明显高于正常肾组织组[OR=16.76,95%CI(8.53,32.92),P<0.000 01],在肾细胞癌伴淋巴结转移组明显高于无淋巴结转移组[OR=4.33,95%CI(2.53,7.39),P<0.000 01],在TNM临床分期Ⅲ~Ⅳ期组明显高于Ⅰ~Ⅱ期组[OR=0.30,95%CI(0.18,0.51),P<0.000 1],在病理分级G3+G4期组明显高于G1+G2期组[OR=0.54,95%CI(0.29,0.98),P=0.04],且差异均有统计学意义;但在肾细胞癌患者年龄≥50岁组与<50岁组[OR=1.09,95%CI(0.54,2.19),P=0.82]、男性组与女性组[OR=0.77,95%CI(0.48,1.25),P=0.29]的表达差异无统计学意义。结论 HIF-1α蛋白的表达与肾细胞癌临床分期和病理分级有显著相关性,其促进了肾细胞癌的形成和发展。受纳入研究数量和质量限制,上述结论尚待开展更多高质量研究加以验证。
Objective To evaluate the relationship between hypoxia inducible factor-1α (HIF-1α) protein expression and renal cell carcinoma and its clinical and pathological features. METHODS: The Cochrane Library, Pub Med, EMbase, CNKI, VIP, CBM and Wan Fang Data were searched by computer. A case-control study published at home and abroad on the correlation between HIF-1α protein expression and renal cell carcinoma and its different clinicopathological features , Search time are from the library to June 2015. Two researchers independently screened literature, extracted data, and assessed the risk of bias in inclusion in the study. Meta-analysis was performed using Rev Man 5.3 software. Results A total of eight case-control studies were included, including 429 cases of renal cell carcinoma and 130 cases of normal renal tissue. Meta-analysis showed that HIF-1αprotein in renal cell carcinoma was significantly higher than that in normal renal tissue [OR = 16.76,95% CI (8.53, 32.92, P <0.000 01], and was significantly higher in patients with renal cell carcinoma with lymph node metastasis (OR = 4.33, 95% CI (2.53, 7.39), P <0.000 01], which were significantly higher than those in stageⅠ-Ⅱ in stageⅢ-Ⅳ TNM clinical staging group [OR = 0.30,95% CI (0.18,0.51), P <0.0001], which was significantly higher in G3 + G4 group than in G1 + G2 group [OR = 0.54,95% CI 0.29,0.98, P = 0.04] (OR = 1.09,95% CI (0.54,2.19), P = 0.82]. There were no significant difference between male and female patients [OR = 0.77 , 95% CI (0.48,1.25), P = 0.29], there was no significant difference between the two groups. Conclusion The expression of HIF-1α protein is significantly correlated with the clinical stage and pathological grade of renal cell carcinoma, which promotes the formation and development of renal cell carcinoma. Subject to the inclusion of the number of studies and the quality restrictions, the above conclusion is yet to be verified by more high-quality studies.