晚期非小细胞肺癌患者化疗疗效与BRCA1表达水平的Meta分析

目的 运用Meta分析BRCA1表达与晚期非小细胞肺癌患者经铂类化疗后疗效之间的关系，探索BRCA1基因表达能否预测铂类化疗的疗效。方法 计算机检索PubMed、CNKI和万方中文数据库，按照制订的纳入与排除标准筛选关于BRCA1表达预测非小细胞肺癌铂类化疗后获益相关的临床研究，检索时限为数据库建库至2015年7月。获得所需的数据，使用RevMan5.4.1进行统计分析。结果 共纳入相关研究19项。Meta分析结果：BRCA1表达阳性患者与阴性患者的铂类化疗疗效无明显差异，合并比值比为0.80（95%CI: 0.54~1.17）。黄种人亚组的BRCA1阴性表达与晚期NSCLC患者铂类化疗敏感度正相关。对检测方法的亚组分析显示：用免疫组织化学、PCR法检测BRCA1表达水平与晚期NSCLC患者铂类药物化疗敏感度无关。BRCA1与晚期NSCLC患者铂类PFS、OS获益并不相关。结论 本组研究异质性较大，BRCA1表达与NSCLC患者对铂类药物化疗后疗效的关系仍应开展更多大样本随机对照试验加以验证。

Prediction Value of BRCA1 for Platinum-based Chemotherapies Effect on Advanced Non-small Cell Lung Cancer Patients: A Meta-analysis

Objective To evaluate the prediction value of BRCA1 for platinum-based chemotherapies effect on advanced non-small cell lung cancer(NSCLC) patients. Methods PubMed, CNKI and Wanfang database were all searched using a computer to collect clinical studies in accordance with the established inclusion and exclusion criteria regarding BRCA1 expression predicted the benefit from platinum-based chemotherapy on NSCLC. The deadline was July 2015. A RevMan 5.4.1 software was used for statistical analysis. Results A total of 19 case-control studies were included in the Meta-analysis. The results showed no associations between BRCA1 expression and the clinical outcomes of platinum-based chemotherapies on advanced NSCLC patients. The pooled OR was 0.80 (95%CI: 0.54-1.17). The subgroup analysis based on ethnicity showed negative BRCA1 expression was in favor of better overall response rate (ORR) in the Asian. The subgroup analysis of the detection method showed BRCA1 expression levels detected by IHC or PCR had no correlation with the sensitivity to platinum-based chemotherapy on patients with advanced NSCLC. BRCA1 was not associated with PFS or OS benefit in advanced NSCLC patients. Conclusion There is no association between BRCA1 expression and the clinical outcomes of platinum-based chemotherapies on advanced NSCLC patients; however, further studies are needed to validate the conclusion.