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目的探讨p16基因和p21基因表达异常对膀胱癌预后的影响。方法以“bladder carcinoma”或“bladder neoplasm”、“prognosis”、“p16”/“p21”和“膀胱癌”、“预后”等为检索词,检索Medline、PubMed、中国生物医学文献及中国学术期刊数据库有关p16基因和p21基因表达异常与膀胱癌预后的文献,应用Meta分析Dersimonian-Laird模型对这些文献进行综合定量评价。结果纳入Meta分析的19篇文献累计病例1584例,阳性率40.4%；其中p16基因表达异常12篇,累计病例975例,阳性率37.4%；p21基因异常表达7篇,累计病例609例,阳性率45.4%。p16基因表达异常、p21基因表达异常、p16基因和p21基因表达异常与膀胱癌预后的合并RH值分别为3.70(95% CI 3.42～3.99)、3.01(95% CI2.81～3.21)和3.18(95% CI 3.01～3.35)。结论p16基因和p21基因表达异常是膀胱癌患者预后不良的生物标记物,有助于膀胱癌的治疗决策。
Objective To investigate the effect of p16 gene and p21 gene on the prognosis of bladder cancer. Methods The term “bladder carcinoma” or “bladder neoplasm”, “prognosis”, “p16” / “p21” and “bladder cancer” and “prognosis” were used as search terms to search Medline, PubMed, Chinese biomedical literature and Chinese academic journals Databases Concerning the literature on the abnormal expression of p16 and p21 genes and the prognosis of bladder cancer, a comprehensive quantitative assessment of these data was performed using the Meta-analysis Dersimonian-Laird model. Results A total of 1584 cases were included in the 19 articles in the meta-analysis, with a positive rate of 40.4%. Among them, 12 were abnormal in p16 gene expression, 975 cases were positive, the positive rate was 37.4%, 7 were abnormal expression of p21 gene, 609 cases were cumulative, 45.4%. The combined RH values of abnormal p16 gene expression, p21 gene expression abnormality, p16 gene and p21 gene expression and prognosis of bladder cancer were 3.70 (95% CI 3.42-3.99), 3.01 (95% CI 2.81-3.13) and 3.18 95% CI 3.01 ~ 3.35). Conclusion The abnormal expression of p16 gene and p21 gene is a biomarker with poor prognosis in patients with bladder cancer, which is helpful for the treatment decision of bladder cancer.