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目的系统评价p STAT3过表达与肺癌预后的相关性。方法计算机检索Pub Med、EMbase、Web of Science、CNKI、VIP和Wan Fang Data等数据库,搜集关于p STAT3过表达与肺癌预后的相关研究,检索时限均为建库至2016年11月。由2位评价者独立进行文献筛选、资料提取和评价偏倚风险后,采用Rev Man 5.2软件进行Meta分析。结果最终纳入13个研究。Meta分析结果显示:p STAT3过表达组的肺癌患者总生存率明显低于p STAT3低表达组[HR=1.23,95%CI(1.04,1.46),P=0.02];临床预后特征方面,肺癌患者Ⅲ~Ⅳ期组的p STAT3过表达阳性率明显高于Ⅰ~Ⅱ期组[OR=1.92,95%CI(1.13,3.27),P=0.02],肺癌伴淋巴结转移组的p STAT3过表达阳性率明显高于不伴淋巴结转移组[OR=1.81,95%CI(1.20,2.72),P=0.004],两组差异均有统计学意义。但p STAT3过表达在肺癌高中分化组和低分化组[OR=0.82,95%CI(0.44,1.53),P=0.54]的差异无统计学意义。结论 p STAT3过表达的肺癌患者总生存率较差,且TNM分期更晚和淋巴结转移率更高,可能是预后不良的指征。受纳入研究数量和质量的限制,上述结论尚待开展更多高质量研究予以验证。
Objective To evaluate the relationship between p STAT3 overexpression and prognosis of lung cancer. Methods The databases of Pub Med, EMbase, Web of Science, CNKI, VIP and Wan Fang Data were searched by computer. The related research about the relationship between p STAT3 overexpression and the prognosis of lung cancer was collected. The search time was from the database to November 2016. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias. Meta-analysis was performed using Rev Man 5.2 software. The results eventually included 13 studies. Meta analysis showed that the overall survival rate of patients with lung cancer with pSTAT3 overexpression was significantly lower than that of patients with low expression of STAT3 [HR = 1.23,95% CI (1.04,1.46), P = 0.02]. In terms of clinical prognosis, The positive rate of p STAT3 overexpression in stage Ⅲ ~ Ⅳ was significantly higher than that in stage Ⅰ ~ Ⅱ [OR = 1.92,95% CI (1.13,3.27), P = 0.02]. The positive expression of p STAT3 in lung cancer with lymph node metastasis The rates were significantly higher than those without lymph node metastasis [OR = 1.81, 95% CI (1.20, 2.72), P = 0.004]. There was significant difference between the two groups. However, there was no significant difference in pSTAT3 overexpression between high-grade lung cancer and low-grade lung cancer [OR = 0.82,95% CI (0.44,1.53), P = 0.54]. Conclusion The overall survival rate of patients with pSTA3 overexpression is poor, and the TNM stage is later and lymph node metastasis rate is higher, which may be an indication of poor prognosis. Due to the limitations of the quantity and quality of the research, the above conclusions have yet to be verified by more high-quality studies.