E-钙黏蛋白异常表达与鼻咽癌临床病理关系的Meta分析

景绍武，徐　庆，王　军，，杨从容，李广庆，赵　珍，赵志军，景尚华

E-钙黏蛋白异常表达与鼻咽癌临床病理关系的Meta分析

景绍武1，徐庆2，王军1，*，杨从容1，李广庆3，赵珍4，赵志军4，景尚华4

（1. 河北医科大学第四医院放疗科，河北石家庄050011；2. 河 北医科大学第四医院超声科，河北石家庄050011；3. 保 定市第七医院肿瘤科，河北保定072150；4. 河北医科大学第四医院耳鼻咽喉-头颈外科，河北石家庄050011）

目的： 探讨E-钙黏蛋白(E-cadherin)在鼻咽癌组织中的异常表达与临床病理的关系，为临床提供参考。方法：计算机检索Cochrane Library、Pubmed、EMbase数据库以及中国生物医学文献数据库、中国学术期刊全文数据库中有关E-cadherin与鼻咽癌研究的文献，采用STATA 11.0软件包进行分析。异常表达、分化程度、T分期、淋巴结转移状况及临床分期采用优势比(OR)及95%可信区间(CI)作为效应量进行分析。结果：入选16篇文献共包括1 040例鼻咽癌患者，结果显示E-cadherin在鼻咽癌组织中的异常表达较正常对照组明显增加(OR=0.096，95% CI：0.036～0.252，P=0.000)；E-cadherin异常表达与分化程度、淋巴结转移及临床分期明显相关(OR= 0.232，95% CI：0.061～0.884，P=0.032；OR=0.324，95% CI：0.198～0.531，P=0.000；OR=0.441，95% CI：0.232～0.835， P= 0.012)。 E-cadherin异常表达者肿瘤分化程度低，更易出现淋巴结转移，肿瘤分期偏晚。结论：E-cadherin在鼻咽癌组织中存在异常表达。E-cadherin可以作为鼻咽癌患者分化程度、淋巴结转移及临床分期的判断指标，值得进一步深入研究。

E-钙黏蛋白；异常表达；鼻咽癌；Meta分析

【ABSTRACT】OBJECTIVE: To understand the relationship between aberrant expression of E-cadherin in nasopharyngeal carcinoma (NPC) and clinicopathological features of NPC patients for clinical applications. METHODS：International publications about E-cadherin and NPC were selected from the Cochrane Library， Pubmed，EMbase database，and Chinese publications were from CBM，CNKI. All analyses were performed by software STATA 11.0. Abnormal expression，degree of differentiation，T stage，lymph node metastasis，and clinical stage were analyzed using pooled odds ratio (OR) with 95% confidence interval (CI). RESULTS：A total of 16 studies including 1040 patients were enrolled in the Meta-analysis. It was shown that expression of E-cadherin was significantly increased in NPC compared to that in normal tissues (OR=0.096，95% CI：0.036-0.252，P=0.000). In addition，the aberrant expression of E-cadherin was significantly associated with the degree of differentiation，lymph node metastasis and clinical stages (OR= 0.232，95% CI：0.061-0.884，P=0.032；OR=0.324，95% CI：0.198-0.53，P=0.000；OR= 0.441，95% CI： 0.232-0.835，P=0.012). CONCLUSION：NPC often showed aberrant expression of E-cadherin. In addition，patients with theaberrant expression were prone to having tumors at lower differentiation，with lymph node metastasis and at late clinical stage. E-cadherin may be an indicator for differentiation，lymph node metastasis and clinical stage.

【KEY WORDS】E-cadherin；aberrant expression；nasopharyngeal carcinoma；Meta-a nalysis

鼻咽癌(nasopharyngeal carcinoma，NPC)是我国南方地区常见的头颈部恶性肿瘤，素有“广东瘤”之称。早期即可向周围及深层浸润，出现淋巴结或血行转移，局部复发和远处转移是NPC患者死亡的主要原因[1]。恶性肿瘤的侵袭和转移是一个极其复杂、多步骤的连续过程，受到多种相关蛋白的调控。……