脑室下区胶质瘤病人生存状况的荟萃分析
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摘要
目的通过Meta分析研究脑室下区(subventricular zone,SVZ)胶质瘤病人的生存状况。方法检索关于SVZ胶质瘤病人生存状况相关的文献,并按特定纳入标准与排除标准进行筛选。采用纽卡斯尔-渥太华量表对所选文献进行质量评价。使用随机效应模型或固定效应模型Meta分析比较SVZ胶质瘤和非SVZ胶质瘤病人中位生存期(overal survival,OS)和中位无进展生存期(progression free survival,PFS)的差异。结果本研究共纳入相关文献16篇。SVZ胶质瘤病人和非SVZ胶质瘤病人的中位OS分别为12.95个月和16.58个月,中位PFS分别为4.54个月和6.25个月。Meta分析结果显示:SVZ胶质瘤病人中位OS (OR=1.59,95%CI:1.35～1.87,P=0.036)及中位PFS (OR=1.44,95%CI:1.25～1.65,P <0.0001),均明显小于非SVZ胶质瘤。对选用多因素回归分析方法的文献进行亚组分析,亦发现SVZ胶质瘤病人中位OS明显小于非SVZ胶质瘤(OR=1.26,95%CI:1.12～1.42,P <0.0001)。结论 SVZ胶质瘤病人预后明显差于非SVZ胶质瘤病人。SVZ胶质瘤是影响胶质瘤病人预后的重要因素之一。
Objective To investigate t he survival status of patients with subventricular zone( SVZ) gliomas by Meta-analysis.Methods The literature about the survival of SVZ glioma patients was searched according to the specific inclusion and exclusion criteria. The quality of selected literature was evaluated by Newcastle-Ottawa Scale. The differences in median overal survival(OS)and median progression free survival(PFS) between SVZ gliomas and non-SVZ glioma patients were analyzed and compared by Meta-analysis using random-effect model or fixed-effect model. Results A total of 16 literatures were analyzed by Meta-analysis. The median OS of SVZ glioma patients and non-SVZ glioma patients was 12.95 months and 16.58 months, and median PFS was 4.54 months and 6.25 months respectively. Meta-analysis showed that the median OS(OR = 1.59, 95%CI:1.35-1.87, P = 0.036) and median PFS(OR = 1.44, 95%CI: 1.25-1.65, P < 0.0001) of SVZ glioma patients were significantly lower than those in non-SVZ glioma patients. The subgroup analysis showed the median OS of SVZ glioma patients was lower than that of non-SVZ glioma patients(OR =1.26, 95% CI:1.12-1.42, P < 0.0001). Conclusions The prognosis of patients with SVZ glioma is significantly worse than that in non-SVZ glioma. SVZ glioma is one of the important factors affecting the prognosis of glioma patients.
Objective To investigate t he survival status of patients with subventricular zone( SVZ) gliomas by Meta-analysis.Methods The literature about the survival of SVZ glioma patients was searched according to the specific inclusion and exclusion criteria. The quality of selected literature was evaluated by Newcastle-Ottawa Scale. The differences in median overal survival(OS)and median progression free survival(PFS) between SVZ gliomas and non-SVZ glioma patients were analyzed and compared by Meta-analysis using random-effect model or fixed-effect model. Results A total of 16 literatures were analyzed by Meta-analysis. The median OS of SVZ glioma patients and non-SVZ glioma patients was 12.95 months and 16.58 months, and median PFS was 4.54 months and 6.25 months respectively. Meta-analysis showed that the median OS(OR = 1.59, 95%CI:1.35-1.87, P = 0.036) and median PFS(OR = 1.44, 95%CI: 1.25-1.65, P < 0.0001) of SVZ glioma patients were significantly lower than those in non-SVZ glioma patients. The subgroup analysis showed the median OS of SVZ glioma patients was lower than that of non-SVZ glioma patients(OR =1.26, 95% CI:1.12-1.42, P < 0.0001). Conclusions The prognosis of patients with SVZ glioma is significantly worse than that in non-SVZ glioma. SVZ glioma is one of the important factors affecting the prognosis of glioma patients.
引文
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[2]CHINOT O L,WICK W,MASON W,et al.Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma[J].N Engl J Med,2014,370(8):709-722.
[3]梅鑫,陈银生,张洁,等.实时监测胶质瘤干细胞分化过程的实验研究[J].中华神经外科杂志,2015,31(9):953-957.
[4]CHEN J,LI Y,YU T S,et al.A restricted cell population propagates glioblastoma growth after chemotherapy[J].Nature,2012,488(7412):522-526.
[5]SANAI N,TRAMONTIN A D,QUINONES-HINOJOSAA,et al.Unique astrocyte ribbon in adult human brain contains neural stem cells but lacks chain migration[J].Nature,2004,427(6976):740-744.
[6]STANG A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.
[7]CHAICHANA K L,MCGIRT M J,FRAZIER J,et al.Relationship of glioblastoma multiforme to the lateral ventricles predicts survival following tumor resection[J].JNeurooncol,2008,89(2):219-224.
[8]CHAICHANA K,PARKER S,OLIVI A,et al.A proposed classification system that projects outcomes based on preoperative variables for adult patients with glioblastoma multiforme[J].J Neurosurg,2010,112(5):997-1004.
[9]KAPPADAKUNNEL M,ESKIN A,DONG J,et al.Stem cell associated gene expression in glioblastoma multiforme:relationship to survival and the subventricular zone[J].JNeurooncol,2010,96(3):359-367.
[10]YOUNG G S,MACKLIN E A,SETAYESH K,et al.Longitudinal MRI evidence for decreased survival among periventricular glioblastoma[J].J Neurooncol,2011,104(1):261-269.
[11]TEJADA-SOLISS,ALDAVE-ORZAIZG,PAY-VALVERDEE,et al.Prognostic value of ventricular wall fluorescence during 5-aminolevulinic-guided surgery for glioblastoma[J].Acta Neurochir(Wien),2012,154(11):1997-2002.
[12]CHAICHANA K L,PENDLETON C,CHAMBLESS L,et al.Multi-institutional validation of a preoperative scoring system which predicts survival for patients with glioblastoma[J].J Clin Neurosci,2013,20(10):1422-1426.
[13]CHEN L,GUERRERO-CA ZARES H,YE X,et al.Increased subventricular zone radiation dose correlates with survival in glioblastoma patients after gross total resection[J].Int J Radiat Oncol Biol Phys,2013,86(4):616-622.
[14]JAFRI N F,CLARKE J L,WEINBERG V,et al.Relationship of glioblastoma multiforme to the subventricular zone is associated with survival[J].Neuro Oncol,2013,15(1):91-96.
[15]ADEBERG S,KONIG L,BOSTEL T,et al.Glioblastoma recurrence patterns after radiation therapy with regard to the subventricular zone[J].Int J Radiat Oncol Biol Phys,2014,90(4):886-893.
[16]SONODA Y,SAITO R,KANAMORI M,et al.The association of subventricular zone involvement at recurrence with survival after repeat surgery in patients with recurrent glioblastoma[J].Neurol Med Chir(Tokyo),2014,54(4):302-309.
[17]LIANG T H,KUO S H,WANG C W,et al.Adverse prognosis and distinct progression patterns after concurrent chemoradiotherapy for glioblastoma with synchronous subventricular zone and corpus callosum invasion[J].Radiother Oncol,2016,118(1):16-23.
[18]HAN S,LI X,QIU B,et al.Can lateral ventricle contact predict the ontogeny and prognosis of glioblastoma[J]?JNeurooncol,2015,124(1):45-55.
[19]PINA BATISTA K M,VEGA I F,DE EULATE-BERAMENDI S A,et al.Prognostic significance of the markers IDH1 and YKL40 related to the subventricular zone[J].Folia Neuropathol,2015,53(1):52-59.
[20]ADEBERG S,HARRABI S B,BOUGATF N,et al.Do increased doses to stem-cell niches during radiation therapy improve glioblastoma survival[J]?Stem Cells Int,2016,2016:8793462.
[21]韩武,郝淑煜,谢坚,等.成人恶性胶质瘤术中脑室开放和肿瘤接近脑室系统与肿瘤脑脊液播散的相关性研究[J].中国微侵袭神经外科杂志,2016,21(7):289-293.
[22]LIU T T,ACHROL A S,MITCHELL L A,et al.Computational identification of tumor anatomic location associated with survival in 2 large cohorts of human primary glioblastomas[J].AJNR,2016,37(4):621-628.
[23]ALCANTARA LLAGUNO S R,WANG Z,SUN D,et al.Adult lineage-restricted CNS progenitors specify distinct glioblastoma subtypes[J].Cancer Cell,2015,28(4):429-440.
[24]KUSNE Y,SANAI N.The SVZ and its relationship to stem cell based neuro-oncogenesis[J].Adv Exp Med Biol,2015,853:23-32.
[25]GOFFART N,KROONEN J,DI VALENTIN E,et al.Adult mouse subventricular zones stimulate glioblastoma stem cells specific invasion through CXCL12/CXCR4signaling[J].Neuro Oncol,2015,17(1):81-94.