Ras癌基因突变在急性髓系白血病患者中的作用:基于2502例病例的荟萃分析

Si Li, Peng-bo Zhang, Yong Zhang, Li Wang
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引用次数: 1

摘要

背景:ras癌基因突变常见于急性髓系白血病(AML),但其作为预后因素尚无定论。方法:检索PubMed、Web of Science、EMBASE、Cochrane等数据库,纳入22项符合条件的研究,采用第2版综合meta分析软件进行分析。所有符合条件的研究的质量评价参照欧洲肺癌党质量量表。结果:综合分析显示,ras癌基因突变对AML患者的生存影响较小(风险比(hr): 1.50, 1.19-1.89, p <0.001)。分层分析显示,Nras基因突变是AML患者较差的生存标志物(HR: 1.97, 95% CI: 1.35 ~ 2.89, p <0.001), Kras基因突变无显著性(HR: 1.32, 95% CI: 0.83 ~ 2.09, p =0.24)。在年龄组分析中,ras基因突变的成人对急性髓系白血病患者的生存不利(HR: 1.55, 95% CI: 1.19 ~ 2.21, p =0.01), ras基因突变的儿童对预后无显著影响(HR: 1.22, 95% CI: 0.97 ~ 1.53, p =0.09)。结论:本研究提示AML患者预后较差,尤其是ras癌基因突变成年组,其中Nras突变参与指导生存,而Kras突变不参与指导生存。
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The Role of Ras Oncogene Mutations in Acute Myeloid Leukemia Patients: A Meta-analysis Based on 2502 Cases
Background: the ras oncogene mutations frequently occurred in acute myeloid leukemia (AML), but as a prognostic factor remains inconclusive. Methods: The databases of PubMed, Web of Science, EMBASE, and the Cochrane. 22 eligible studies were included this study and analysis was conducted by Comprehensive Meta-Analysis Version 2 software program. All eligible study’s quality assessment refers to the European Lung Cancer Party quality scale. Results: Combined analysis showed that ras oncogene mutation was a poor impact on survival in AML patients (Hazard ratios (HRs): 1.50, 1.19-1.89, p <0.001). Nras gene mutation was a worse survival marker in AML (HR: 1.97, 95% CI: 1.35-2.89, p <0.001) and Kras gene mutations was no significance (HR: 1.32, 95% CI: 0.83-2.09, p =0.24) by stratified analysis. In the analysis of age bracket, adults with ras gene mutation had an unfavorable survival (HR: 1.55, 95% CI: 1.19-2.21, p =0.01) and children harbored ras gene mutation was not significantly with prognosis (HR: 1.22, 95% CI: 0.97-1.53, p =0.09) in AML. Conclusions: This study indicated that AML patients was poor prognosis especially in adult group with ras oncogene mutation, in which Nras mutation, but not Kras mutation involved in guiding survival.
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