Predictive and Prognostic Roles of Ribonucleotide Reductase M1 in Patients with Pancreatic Cancer Treated with Gemcitabine: A Meta-analysis

Increasing scientific evidence suggests that ribonucleotide reductase M1 (RRM1) may be a powerful predictorof survival in patients with pancreatic cancer treated with adjuvant gemcitabine-based chemotherapy afteroperative resection, but many existing studies have yielded inconclusive results. This meta-analysis aimedto assess the prognostic role of RRM1 in predicting survival in patients with pancreatic cancer treated withgemcitabine. An extensive literature search for relevant studies was conducted on PubMed, Embase, Web ofScience, Cochrane Library, and CBM databases from their inception through May 1st, 2013. This meta-analysiswas performed using the STATA 12.0 software and crude hazard ratios (HRs) with 95% confidence intervals(CIs) were calculated. Eight clinical studies were included in this meta-analysis with a total of 665 pancreaticcancer patients treated with adjuvant gemcitabine-based chemotherapy, including 373 patients in the high RRM1expression group and 292 patients in the low RRM1 expression group. Our meta-analysis revealed that highRRM1 expression was associated with improved overall survival (OS) of pancreatic cancer patients (HR=1.56,95%CI=0.95-2.17, P<0.001). High RRM1 expression also was linked to longer disease-free survival (DFS) thanlow RRM1 expression (HR=1.37, 95%CI=0.25-2.48, P=0.016). In conclusion, our meta-analysis suggests thathigh RRM1 expression may be associated with improved OS and DFS of pancreatic cancer patients treated withadjuvant gemcitabine-based chemotherapy. Detection of RRM1 expression may be a promising biomarker forgemcitabine response and prognosis in pancreatic cancer patients.     

Prognostic Impact of Elevation of Vascular Endothelial Growth Factor Family Expression in Patients with Non-small Cell lung Cancer: an Updated Meta-analysis

Background: The vascular endothelial growth factor family has been implicated in tumorigenesis andmetastasis. The prognostic value of each vascular endothelial growth factor family member, particular VEGF/VEGFR co-expression, in patients with non-small lung cancer remains controversial. Materials and Methods:Relevant literature was identified by searching PubMed, EMBASE and Web of Science. Studies evaluatingexpression of VEGFs and/or VEGFRs by immunohistochemistry or ELISA in lung cancer tissue were eligiblefor inclusion. Hazard ratios (HRs) and 95% confidence intervals (CIs) from individual study were pooled byusing a fixed- or random-effect model, heterogeneity and publication bias analyses were also performed. Results:74 studies covering 7,631 patients were included in the meta-analysis. Regarding pro-angiogenesis factors, theexpression of VEGFA (HR=1.633, 95%CI: 1.490-1.791) and VEGFR1 (HR=1.924, 95%CI: 1.220-3.034) wasassociated separately with poor survival. Especially, VEGFA over-expression was an independent prognosticfactor in adenocarcinoma (ADC) (HR=1.775, 95%CI: 1.384-2.275) and SCC (HR=2.919, 95%CI: 2.060-4.137).Co-expression of VEGFA/VEGFR2 (HR=2.011, 95%CI: 1.405-2.876) was also significantly associated with worsesurvival. For lymphangiogenesis factors, the expression of VEGFC (HR=1.611, 95%CI: 1.407-1.844) predicteda poor prognosis. Co-expression of VEGFC/VEGFR3 (HR=2.436, 95%CI: 1.468-4.043) emerged as a preferableprognostic marker. Conclusions: The expression of VEGFA (particularly in SCC and early stage NSCLC),VEGFC, VEGFR1 indicates separately an unfavorable prognosis in patients with NSCLC. Co-expression VEGFA/VEGFR2 is comparable with VEGFC/VEGFR3, both featuring sufficient discrimination value as preferable asprognostic biologic markers.     

Influence of Perineural Invasion on Survival and Recurrence in Patients with Resected Pancreatic Cancer

Background: Perineural invasion (PNI) has been reported as one of the sources of locoregional recurrence inresected pancreatic cancer (PC). However the impact of PNI in resected pancreatic cancer remains controversial.The purpose of this study was to determine the association between PNI status and clinical outcomes. Methods:Publications were identified which assessed prognostic significance of PNI status in resected pancreatic cancerup to February 2013. A meta-analysis was performed to clarify the association between PNI status and clinicaloutcomes. Results: A total of 21 studies met the inclusion criteria, covering 4,459 cases. Analysis of these datashowed that intrapancreatic PNI was correlated with reduced overall survival only in resected pancreaticductal adenocarcinoma (PDAC) patients (HR=1.982, 95%CI: 1.526-2.574, p=0.000). Extrapancreatic PNI wascorrelated with reduced overall survival in all resected pancreatic cancer patients (HR=1.748, 95%CI: 1.372-2.228, p=0.000). Moreover, intrapancreatic PNI status may be associated with tumor recurrence in all resectedpancreatic cancer patients (HR=2.714, 95%CI: 1.885-3.906, p=0.000). Conclusion: PNI was an independent andpoor prognostic factor in resected PDAC patients. Moreover, intrapancreatic PNI status may be associated withtumor recurrence.     

Prognostic Value of MMP-9 in Ovarian Cancer: A Meta-analysis

Objective: Matrix metalloproteinase-9(MMP-9) plays an important role in tumor cell invasion. Althoughit has been studied frequently in ovarian cancer, its prognostic impact is still equivocal. The aim of this studywas to more precisely estimate its prognostic significance. Method:We searched Pubmed, Embase, OVID,Sciencedirect and CBM databases to identify eligible studies. Hazard ratios (HRs) or odds ratios (ORs) with 95%confidence intervals (95% CIs) were pooled across studies using fixed-effects or random-effects models. We alsoperformed subgroup analysis. Results: 30 studies (n=2552 patients) focusing on prognosis or expression of MM-9were included. Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients(HR=1.68, 95%CI 1.09-2.59, p=0.02). Besides, MMP-9 expression in ovarian cancer was significantly higher thannon-malignant tumors (OR=11.46, 95%CI 8.47-15.50, P<0.00001). Moreover, increased expression of MMP-9was significantly associated with FIGO stage (OR=4.85, 95%CI 2.60-9.04, P<0.00001), grade of differentiation(OR=3.34, 95%CI 2.46-4.54, P<0.00001), lymph node metastasis (OR=5.75, 95%CI 3.71-8.92, P<0.00001) andthere was no association with histological type of ovarian cancer. Conclusions: Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients. Down-regulation of MMP-9 is an attractivetherapeutic approach which might improve outcome of ovarian cancer.     

长链非编码RNA作为食管癌潜在的预后生物标志物的系统评价及荟萃分析

目的通过系统回顾和荟萃分析探讨多种长链非编码RNA(lncRNA)在食管癌预后预测中的价值。方法在PubMed、Embase、Web of Science、中国知网和万方数据库中检索相关文献,检索关键词为"lncRNA""食管癌"。应用风险比(HR)及95%置信区间(CI)分析lncRNA表达情况与食管癌患者预后的关系,采用Stata 15.0软件进行数据分析。结果本研究共纳入25篇文献,3830例患者,22种不同的lncRNA与食管癌患者预后有关。通过荟萃分析确定了HOTAIR和MALAT1对食管癌患者的预后价值。合并效应量后的荟萃分析结果显示,HOTAIR过表达与食管癌患者生存期较短有关(HR=2.404,95%CI:1.661~3.479,P﹤0.01)。MALAT1的表达情况与食管癌患者的预后无明显相关性(HR=3.384,95%CI:0.948~12.082,P=0.060)。结论 lncRNA尤其是HOTAIR可能是食管癌的潜在预后标志物。     

ERCC1在结直肠癌组织中的表达及预后价值

目的:探究核苷酸切除修复交叉互补基因1（excision repair cross-complementation gene 1，ERCC1）表达对结直肠癌（colorectal cancer，CRC）患者铂类辅助化疗的预后价值。方法:选取2011年01月至2013年01月安徽医科大学附属六安医院行CRC根治术后接受mFOLFOX6方案化疗的患者共84例，通过免疫组化方法评估ERCC1在CRC组织中表达情况，分析ERCC1表达与预后的关联。结果:ERCC1高表达30例（35.7%）。Kaplan-Meier曲线显示ERCC1高表达的CRC患者无病生存期（DFS）和总生存期（OS）均缩短（P均<0.001）。多因素COX分析显示ERCC1高表达（DFS HR=4.645，95%CI:2.045~10.548，P<0.001；OS HR=4.898，95%CI:1.971~12.170，P<0.001）是CRC患者预后的不良因素，分析各亚组患者中ERCC1表达与生存相关性得到相似的结果。复发患者中ERCC1高表达的肝肺转移占68.8%（11/16），低表达的腹腔转移为70.0%（7/10），ERCC1表达与首次复发模式显著相关（P=0.006）。结论:ERCC1表达可作为评价CRC患者预后的重要指标。ERCC1表达可能有助于预测CRC患者辅助化疗后首次复发模式。ERCC1表达的预后价值需进一步研究。     

KIF11表达水平与肿瘤患者预后相关性的Meta分析

目的:荟萃分析探讨kinesin家族成员11（kinesin family member 11,KIF11）表达与肿瘤患者临床病理特征的关系,并评估KIF11表达在肿瘤患者中预后的意义。方法:全面检索PubMed、EmBase、CNKI、Web of Science、万方等数据库中的相关文献。计算危险比（HR）和优势比（OR）及95%置信区间（CI）以评估KIF11表达与生存期及临床病理特征的关系。结果:最终纳入12项研究,涉及1 951例患者。结果表明KIF11表达升高与较差的生存率（HR=2.06,95%CI:1.36~3.12,P＜0.001）及疾病进展（HR=2.26,95%CI:1.64~3.13,P＜0.001）显著相关。此外,高表达KIF11患者更倾向于TNM分期晚期(OR=3.39,95%CI:2.47~4.66,P＜0.001)、肿瘤浸润深度较深(OR=2.01,95%CI:1.03~3.43,P＜0.001)、淋巴结转移(OR=2.78,95%CI:1.29~6.02,P＜0.001)。结论:增强的KIF11表达可能预测多种肿瘤的不良预后,可作为评估肿瘤患者预后的潜在生物标记物。     

细胞周期S期激酶相关蛋白2预测乳腺癌预后价值的Meta分析

目的:基于现有文献的Meta分析试阐述Skp2对乳腺癌（breast cancer,BC）预后的价值。方法:2015年10月之前在PubMed、EMBASE和Web of Science等数据库检索到的符合标准的研究。在95%可信区间（confidence interval,CI）内,以风险比（hazard ratio,HR）阐明Skp2表达和BC临床结果之间的相关性,包括总存活数（overall survival,OS）、无病生存数（disease-free survival,DFS）和BC带病生存数。结果:共计9个研究包括1 820个病例。Meta分析结果表明:Skp2过表达与BC患者低OS（HR=2.58,95%CI:1.83~3.63,P=0.000）和低DFS（HR=2.12,95%CI:1.48~3.05,P=0.000）相关。结论:Skp2过表达是肿瘤低生存率的独立危险因素。     

基于Oncomine和Kaplan-Meier Plotter数据库分析GPX2在非小细胞肺癌组织中的表达和临床意义

目的:探讨谷胱甘肽过氧化物酶2（glutathione peroxidase 2,GPX2）在非小细胞肺癌组织中的表达及预后意义。方法:基于Oncomine和Kaplan-Meier Plotter数据库,收集关于GPX2表达的相关数据集,深入挖掘GPX2在非小细胞肺癌组织与正常组织中的差异表达情况。采用Kaplan-Meier法进行预后分析,并绘制生存曲线。此外,通过单/多因素COX回归进一步评估GPX2在不同临床特征中的预后评估价值。结果:与正常组织相比,GPX2在非小细胞肺癌组织中高表达（P＜0.001）。 GPX2高表达非小细胞肺癌患者的总体生存率（HR=1.42,95%CI:1.25~1.61,P=5.6E-08）和肺腺癌患者的总体生存率（HR=1.35,95%CI:1.07~1.71,P=0.011）均差于低表达组。但GPX2表达水平对鳞癌患者预后无显著影响（HR=1.06,95%CI:0.84~1.35,P=0.61）。此外,本研究也发现GPX2的表达对同一临床特征（如男性、临床分期、吸烟/不吸烟、经化疗方式治疗）的患者的预后有预测评估价值。多因素分析结果显示临床分期和GPX2的表达是非小细胞肺癌患者预后的独立影响因素。结论:检测非小细胞肺癌组织中GPX2的表达有助于患者预后评估。     

血小板与淋巴细胞比率对胃癌预后影响的Meta分析

目的:探讨血小板与淋巴细胞比率(platelet-lymphocyte ratio,PLR)对胃癌患者预后评估的价值。方法:检索PubMed、Medline、Embase、Cochrane Library和中文数据库如中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期刊全文数据库等,纳入关于PLR和胃癌患者预后关系的中英文文献,由2名研究者独立选择文献和提取数据资料并对纳入文献进行质量评估,采用Review Manager 5.3和Stata 15.1软件进行统计分析。结果:最终共纳入29项符合标准的研究,共计13696名胃癌患者。Meta分析结果显示治疗前高水平PLR的胃癌患者,其总生存期(overall survival,OS)明显缩短(HR=1.13,95%CI:1.03~1.24,P=0.01),但是与无病生存期(disease-free survival,DFS)(HR=1.19,95%CI:0.79~1.81,P=0.41)和无进展生存期(progression-free survival,PFS)(HR=1.10,95%CI:0.88~1.37,P=0.41)没有明显相关性。结论:治疗前高水平PLR是胃癌患者OS较短的重要临床预后指标,为临床医务工作人员评价胃癌患者的预后提供依据。但是仍需要更多大规模、多中心、更全面的实验研究进行验证。     

晚期胰腺癌患者应用GS方案一线化疗引起的中性粒细胞减少与预后的相关性

目的:探讨晚期胰腺癌患者应用吉西他滨联合替吉奥方案一线化疗引起的中性粒细胞减少(chemotherapy induced neutropenia,CIN)与预后的相关性。方法:回顾性分析2012年7月至2016年6月,接受吉西他滨联合替吉奥方案一线化疗的37例晚期胰腺癌患者,根据CTCAE(common terminology criteria for adverse events) 4.0的标准,将中性粒细胞减少分级为G0级,G1级,G2级,G3级,G4级。观察患者化疗2周期内出现的中性粒细胞减少程度,利用Kaplan-Meier曲线和COX风险模型分析CIN与总生存时间（OS）的相关性。结果:晚期胰腺癌患者接受吉西他滨联合替吉奥方案一线化疗后,未发生CIN（0级）的患者中位总生存期为158天（95%CI:128~187天）,发生CIN（1-4级）患者中位总生存期294天（95%CI,211~368天）。多因素分析显示,发生CIN（HR:0.379,95%CI:0.177~0.811,P=0.012）和接受二线化疗（HR:0.426,95%CI:0.186~0.976,P=0.044）是晚期胰腺癌患者接受吉西他滨联合替吉奥方案一线化疗的独立预后因素。结论:CIN是晚期胰腺癌一线GS方案化疗判断预后的独立影响因素,监测CIN将有助于早期判断预后并及时调整化疗药物剂量。     

胰腺癌中Circ_0001946的表达及其与患者预后的相关性

目的 探讨Circ_0001946在胰腺癌患者中的表达及其与患者预后的相关性。方法 qRT-PCR法检测Circ_0001946在胰腺癌患者组织及血清标本中的表达,Chi-Square检验分析Circ_0001946与各临床病理参数之间的关系;Kaplan-Meier法分析Circ_0001946的表达与生存时间及预后的关系,单因素及多因素Cox分析影响胰腺癌患者预后的因素,ROC曲线分析其作为胰腺癌早期诊断生物标志物的效能。结果 Circ_0001946在胰腺癌患者组织和血清中高表达,差异有统计学意义（均P<0.001）。Circ_0001946与脉管癌栓、淋巴结转移、CA199的表达及疾病分期显著相关（均P<0.05）。血清Circ_0001946表达与AFP的量呈正相关关系（r=0.765, P=0.000）。血清Circ_0001946作为诊断胰腺癌血清标志物的ROC曲线下面积为0.805（95%CI: 0.754~0.927, P=0.000）。高表达Circ_0001946的患者总生存时间及无进展生存时间均较低表达者明显缩短（均P=0.000）。单因素及多因素Cox分析结果显示,疾病分期、Circ_0001946表达及脉管癌栓是胰腺癌患者预后的独立影响因素。结论 Circ_0001946在胰腺癌患者中高表达,与患者的预后相关。     

Prognostic Significance of Circulating Tumor Cells in Small-Cell Lung Cancer Patients: a Meta-analysis

Circulating tumor cells (CTCs) are believed to be particularly important and a reliable marker of malignancy.However, the prognostic significance of CTCs detected in patients with small cell lung cancer (SCLC) is stillunclear. We therefore aimed to assess the prognostic relevance of CTCs using a meta-analysis. We searchedPubMed for relevant studies and statistical analyses were conducted to calculate the hazard ratio (HR) and95% confidence intervals (CIs) using fixed or random-effect models according to the heterogeneity of includedstudies. A total of 7 papers covering 440 SCLC patients were combined in the final analysis. The meta-analysisrevealed that CTCs were significantly associated with shorter overall survival (HR=1.9; 95%CI: 1.19-3.04;Z=2.67; P<0.0001) and progression-free survival (HR=2.6; 95%CI: 1.9-3.54; Z=6.04; P<0.0001). The resultsthus suggest that the presence of CTCs indicates a poor prognosis in patients with SCLC. Further well-designedprospective studies are required to explore the clinical applications of CTCs in SCLC.     

MTA1表达与中国肺癌患者预后关系的meta分析

背景与目的 已有的研究表明:在多种恶性肿瘤中发现转移相关蛋白1(metastasis associated protein 1, MTA1)发挥着促进肿瘤侵袭与转移的作用,且与肿瘤患者预后不佳有关.目前MTA1在肺癌中的预后作用仍有争议,故我们采用meta分析的方法评估其在肺癌患者中的预后价值.方法 通过计算机检索PubMed、Embase、万方数据库、中国生物医学文献数据库、中国知网等数据库,收集纳入研究MTA1表达与肺癌预后关系的文献及相关数据,采用Stata 12.0软件进行数据分析,合并值为风险比(hazard ratio, HR).结果 总共纳入8项研究共712例中国肺癌患者,对这些研究进行异质性检验,发现存在异质性(I2=59.0%,P=0.017),故采用随机效应模型进行数据合并得HR=2.07(95%CI: 1.42-3.02, P<0.001).同时分层分析显示在非小细胞肺癌(non-small cell lung can-cer,NSCLC)中各研究无明显异质性(I2=47.0%,P=0.093),采用固定效应模型合并得HR=1.66(95%CI:1.27-2.18, P<0.001).结论 MTA1高表达可能是中国NSCLC患者预后不良的一个指标,在肺癌及小细胞肺癌中的预后价值尚缺乏证据.     

联合MORC2-IDH1检测对胶质母细胞瘤放化疗患者分子分型价值

目的 研究MORC2在胶质母细胞瘤组织中的表达及其联合IDH1突变状态对放化疗疗效的预测作用及分子分型价值。方法 应用免疫组化检测45例胶质母细胞瘤组织中MORC2表达水平,分析其与患者临床特征及放化疗预后间关系。通过胶质瘤转录组数据库进一步联合分析MORC2转录水平及IDH1突变状态对胶质母细胞瘤患者放化疗预后意义。结果 胶质母细胞瘤患者中MORC2蛋白高表达率为76%,且与放化疗预后总生存及无复发生存呈负相关(HR=2.928,95%CI为1.582~5.418,P=0.002;HR=2.204,95%CI为1.186~4.095,P=0.022)。联合IDH1突变状态、MORC2转录水平可将胶质母细胞瘤术后接受放化疗患者分为3个亚型,其中IDH1突变型(IDH1^mt)伴MORC2低表达(MORC2^low)者预后最好,中位生存期为22个月(95%CI为13.98~30.02),而IDH1野生型(IDH1^wt)伴MORC2高表达(MORC2^high)者预后最差,中位生存期为5.63个月(95%CI为3.92~7.34)(HR=4.15,95%CI为1.606~10.720,P=0.002)。在IDH1^wt中MORC2^high比MORC2^low预后更差,提示IDH1^wt/MORC2^high胶质母细胞瘤组织具有更强的DNA损伤修复能力,对放化疗治疗更抗拒。结论 MORC2^high可作为胶质母细胞瘤患者潜在的放化疗预后不良的指标,联合IDH1突变状态及MORC2表达水平可建立一种新的分子分型,为分层治疗提供依据。     

Prognostic Significance of p53 in Gastric Cancer: a Meta-Analysis

Background: Gastric cancer is one of the frequently seen cancers in the world and it is the second most commonreason for death due to cancer. The prognostic role of expression of p53 detected by immunohistochemistry ingastric cancer remains controversial. This meta-analysis aimed to explore any association between overexpressionand survival outcomes. Materials and Methods: We systematically searched for studies investigating therelationships between expression of p53 detected by immunohistochemistry and prognosis of gastric cancerpatients. Study quality was assessed using the Newcastle-Ottawa Scale. After careful review, survival datawere extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios foroverall survival and disease-free survival. Results: A total of 4.330 patients from 21 studies were included inthe analysis. Our results showed tissue p53 overexpression in patients with gastric cancer to be associated withpoor prognosis in terms of overall survival (HR, 1.610; 95% CI, 1.394 -5.235; p:<0.001). Pooled hazard ratiofor disease free survival showed that p53 positivity or negativity were not statitistically significant (HR, 1.219;95%CI, 0.782-1.899; p:0.382). Conclusions: The present meta-analysis indicated overexpression of p53 detectedby immunohistochemistry to be associated with a poor prognosis in patients with gastric cancer.     

不同基因分型晚期非小细胞肺癌患者的预后分析

背景与目的 非小细胞肺癌(non-small cell lung cancer,NSCLC)已由原来的组织分型指导下的治疗转变为基因分型指导治疗的模式,表皮生长因子受体(epidermal growth factor receptor,EGFR)和间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)是肺癌最重要的两个驱动基因.本研究旨在探讨不同基因分型的复发或转移晚期NSCLC患者的临床特点及预后影响因素.方法 回顾性分析北京胸科医院2004年7月-2015年12月间553例EGFR和ALK基因状态明确的晚期NSCLC患者的临床资料,采用Cox比例风险回归模型对患者预后的独立影响因素进行分析.结果 553例细胞学或组织学证实的晚期NSCLC患者,EGFR突变患者227例,ALK阳性患者58例,EGFR和ALK双突变患者2例,EGFR和ALK野生型患者266例.227例EGFR突变患者的中位生存期(overall survival,OS)为28.7个月(95%CI:22.160-35.240),体能状态(performance status,PS)评分为0分-1分(HR=4.451;95%CI:2.112-9.382;P<0.001)、接受EGFR-酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)靶向治疗(HR=2.785;95%CI:1.871-4.145;P<0.001)是EGFR突变患者生存的独立影响因素.58例ALK阳性患者的中位OS为15.5个月(95%CI:10.991-20.009),接受克唑替尼靶向治疗(P=0.022)是ALK阳性患者生存的独立影响因素.266例野生型患者的中位OS为12.1个月(95%CI:10.660-13.540),PS评分为0分-1分(HR=2.313;95%CI:1.380-3.877;P=0.001)、接受化疗(HR=1.911;95%CI:1.396-2.616;P<0.001)是野生型患者生存的独立影响因素.结论 不同基因型的晚期NSCLC患者的预后差异较大,靶向治疗可改善EGFR突变、ALK阳性患者生存.     

Prognostic Value of Tissue Vascular Endothelial Growth FactorExpression in Bladder Cancer: a Meta-analysis

Objective: The prognostic role of vascular endothelial growth factor (VEGF) in bladder cancer remainscontroversial. This meta-analysis aimed to explore any association between overexpression and survival outcomes.Methods: We systematically searched for studies investigating the relationships between VEGF expression andoutcome of bladder cancer patients. Study quality was assessed using the Newcastle-Ottawa Scale. After carefulreview, survival data were extracted from eligible studies. A meta-analysis was performed to generate combinedhazard ratios (HRs) for overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS).Results: A total of 1,285 patients from 11 studies were included in the analysis. Our results showed that tissueVEGF overexpression in patients with bladder cancer was associated with poor prognosis in terms of OS (HR,1.843; 95% CI, 1.231-2.759; P = 0.003), DFS (HR, 1.498; 95% CI, 1.255-1.787; P = 0.000) and DSS (HR, 1.562;95% CI, 0.996-1.00; P = 0.052), though the difference for DSS was not statistically significant. In addition, therewas no evidence of publication bias as suggested by Begg’s and Egger’s tests except for DFS (Begg’s test, P =0.221; Egger’s test, P = 0.018). Conclusion: The present meta-analysis indicated elevated VEGF expression tobe associated with a poor prognosis in patients with bladder cancer.     

Prognostic Value of NRAS Gene for Survival of Colorectal Cancer Patients: A Systematic Review and Meta-Analysis

Introduction: NRAS gene is associated with malignant proliferation and metastasis of colorectal cancer (CRC).But its prognostic value on CRC is still unknown. The objective of this study is to perform a meta-analysis to obtainits prognostic value on survival of CRC patients. Methods: The systematic review and meta-analysis was designed,undertaken and reported using items from the PRISMA statement. Relevant articles were identified through PubMed(containing Medline), Embase, Web of Science databases and Google scholar search engines from their inception up toOctober 3, 2016. The articles about NRAS on prognosis of CRC patients were enrolled. The association between NRASand CRC survival time (including overall survival [OS], progression-free survival [PFS], and disease-free survival[DFS]) was evaluated using hazard ratio (HR) with its corresponding 95% confidence interval (CI). Results: A totalof fifteen articles were included. High-expression of NRAS was significantly associated with poor OS (HR: 1.36, 95%CI: 1.15–1.61), and poor PFS (HR: 1.75, 95% CI: 1.04–2.94). The combined HR of NRAS on DFS was 0.87 (95% CI:0.37–2.03). Subgroup analysis showed that NRAS was significantly associated with poor OS for patients from Westerncountries (HR: 1.38, 95% CI: 1.09–1.73), but not for those from Asian countries. Conclusions: This meta-analysisdemonstrate that NRAS gene could predict the poor prognosis for the CRC patients. More large-sample cohort studiesare needed to further confirm this conclusion.