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目的系统评价有关食管鳞状细胞癌(ESCC)组织中CXCR4表达及临床意义的研究。方法计算机检索PubMed、EMbase、Web of Science、CBM、VIP、CNKI和WanFang Data,并辅以文献追溯的方法收集国内外发表的相关病例-对照研究,检索时限均从建库至2012年4月。由两位研究者按纳入和排除标准筛选文献并评价纳入研究质量后,应用RevMan 5.1软件进行Meta分析。结果共纳入5个病例-对照研究,包含ESCC组织493例,正常食管组织136例。Meta分析结果显示:在CXCR4表达方面,ESCC组织比正常组织高[OR=12.03,95%C(I6.76,21.44),P<0.000 01],有淋巴结转移的ESCC组织比无淋巴结转移的高[OR=4.35,95%CI(2.48,7.62),P<0.000 01],中低分化的ESCC组织比高分化的高[OR=0.51,95%CI(0.32,0.81),P=0.004];ESCC组织临床Ⅰ～Ⅱ期和临床Ⅲ～Ⅳ期CXCR4表达的差异无统计学意义[OR=0.63,95%CI(0.08,4.99),P=0.66],但敏感性分析显示该结果不可靠。结论现有有限证据表明,CXCR4表达与ESCC及其有无淋巴结转移和不同组织学分级有关,说明CXCR4在ESCC发生、发展过程中可能起重要作用,但其与ESCC临床分期间的关系尚不确定,需要进行更多大样本、设计严谨的高质量研究来进一步证实。
Objective To evaluate the expression of CXCR4 in esophageal squamous cell carcinoma (ESCC) and its clinical significance. Methods PubMed, EMbase, Web of Science, CBM, VIP, CNKI and WanFang Data were searched by computer. The related case-control studies published at home and abroad were supplemented with literature retrospective search. The search time was from the database to April 2012. After two investigators screened the literature for inclusion and exclusion criteria and evaluated the quality of the included studies, Meta-analysis was performed using RevMan 5.1 software. Results A total of 5 case-control studies were included, including 493 ESCC cases and 136 normal esophageal tissues. Meta-analysis showed that the expression of CXCR4 in ESCC tissues was higher than that in normal tissues [OR = 12.03, 95% C (I6.76, 21.44), P <0.000 01]. ESCC tissues with lymph node metastasis were higher than those without lymph node metastasis (OR = 4.35, 95% CI (2.48, 7.62, P <0.000 01). The poorly differentiated ESCC tissues were highly differentiated (OR = 0.51, 95% CI 0.32, 0.81, P = 0.004) There was no significant difference in the expression of CXCR4 between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ in ESCC tissues [OR = 0.63,95% CI (0.08, 4.99), P = 0.66]. However, sensitivity analysis showed that the results were not reliable. Conclusions There is limited evidence to show that the expression of CXCR4 is correlated with ESCC, with or without lymph node metastasis and histological grade, indicating that CXCR4 may play an important role in the development and progression of ESCC. However, its relationship with the clinical stage of ESCC is uncertain , Require more large samples, rigorous design of high-quality research to further confirm.