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目的系统评价E-cadherin蛋白的表达与胰腺癌发病风险的相关性。方法计算机检索Pub Med、EMbase、The Cochrane Library、CNKI、VIP、CBM和Wan Fang Data数据库,搜集2016年10月1日前国内外公开发表的关于E-cadherin蛋白的表达与胰腺癌发病风险相关性的病例-对照研究。由2名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 5.2和Stata 12.0软件进行Meta分析。结果最终纳入17个病例-对照研究,包括胰腺癌组986例,癌旁正常组织组433例。Meta分析结果显示:(1)E-cadherin蛋白表达在胰腺癌组低于癌旁正常组织组[OR=0.04,95%CI(0.01,0.23),P=0.000 2],在低分化组低于高中分化组[OR=0.44,95%CI(0.26,0.76),P=0.003],在伴淋巴结转移组低于无淋巴结转移组[OR=0.50,95%CI(0.31,0.81),P=0.005],其差异均有统计学意义。(2)E-cadherin蛋白表达在Ⅰ~Ⅱ期组与Ⅲ~Ⅳ期[OR=0.63,95%CI(0.25,1.59),P=0.33],胰头癌组与胰体尾癌组[OR=1.22,95%CI(0.72,2.07),P=0.46],伴神经侵犯组与无神经侵犯组[OR=1.45,95%CI(0.81,2.62),P=0.21],伴血管侵犯组与无血管侵犯组[OR=0.55,95%CI(0.13,2.22),P=0.40]的差异无统计学意义。结论 E-cadherin蛋白的低表达与胰腺癌发病风险明显相关。受纳入研究的数量和质量的限制,上述结论尚需开展更多研究予以证实。
Objective To evaluate the relationship between the expression of E-cadherin and the risk of pancreatic cancer. Methods PubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and Wan Fang Data were searched by computer. The data of E-cadherin protein expression in pancreatic cancer were collected before October 1, 2016 Case-control study. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in inclusion in the study. Meta-analysis was performed using Rev Man 5.2 and Stata 12.0 software. Results A total of 17 case-control studies were included, including 986 in the pancreatic cancer group and 433 in the normal paracancer group. The results of Meta analysis showed that: (1) The expression of E-cadherin protein in pancreatic cancer group was lower than that in adjacent normal tissue [OR = 0.04,95% CI (0.01,0.23, P = 0.0002] (OR = 0.44,95% CI (0.26,0.76), P = 0.003]. In the group with lymph node metastasis, it was lower than those without lymph node metastasis [OR = 0.50,95% CI (0.31,0.81), P = 0.005 ], The differences were statistically significant. (2) The expression of E-cadherin in stage Ⅰ ~ Ⅱ group and stage Ⅲ ~ Ⅳ [OR = 0.63,95% CI (0.25,1.59), P = 0.33] (OR = 1.45, 95% CI 0.81, 2.62, P = 0.21), with or without vascular invasion and with or without neurological involvement (OR = 1.22,95% CI 0.72,2.07, P = 0.46) There was no significant difference in no vascular invasion group [OR = 0.55, 95% CI (0.13, 2.22), P = 0.40]. Conclusion The low expression of E-cadherin protein is significantly associated with the risk of pancreatic cancer. Due to the limited number and quality of studies included, more research is needed to confirm these conclusions.