作者：吴彬江，张玉领，李雪甫，陈培

单位：江苏护理职业学院，江苏 淮安 223005

Authors: Wu Binjiang，Zhang Yuling，Li Xuefu，Chen Pei

Unit: Jiangsu College of Nursing, Huai'an 223005, Jiangsu, China

摘要：

目的 探讨SIRT1与胃癌临床病理特征的相关性，为胃癌早期诊断和预后评估提供依据。方法 在Pubmed、Embase、CNKI和万方数据库中在线检索关于SIRT1表达与胃癌相关性的研究文献，检索截止日期至2021年7月。中文检索关键词为“SIRT1、信息调节因子1、胃癌、临床病理特征”等，英文检索关键词为“SIRT1、Sirtuin1、gastric carcinoma、gastric cancer、clinicopathological variables”。初筛共检索文献454篇，去除重复文献153篇后剩余301篇，去除会议论文、综述、病例报道和动物研究281篇后剩余20篇。通过阅读全文，最终纳入Meta分析14篇文献。主要分析探讨SIRT1在胃癌和正常对照组织中的表达情况以及SIRT1表达与胃癌临床病理特征如分化程度、浸润深度等相关性。采用STATA 16.0软件进行数据分析，通过统计量I2和相应的P为依据判断个研究间的异质性，采用OR及其95%CI和Z检验对合并效应变量进行分析。采用Beggs漏斗图及其对应的t检验进行发表偏倚评价。结果 根据纳入和排除标准，共纳入12篇文献，包括胃癌黏膜组织2228例，癌旁或正常对照胃黏膜组织550例。与癌旁或正常对照组相比，SIRT1在胃癌组织中显著高表达(OR=6.84,95%CI:3.92～11.93),P<0.05。SIRT1表达与胃癌分型(OR=1.88,95%CI:1.08～3.29)、浸润深度(OR=0.44,95%CI:0.24～0.80)、临床分期(OR=0.51,95%CI:0.33～0.79)、淋巴结转移(OR=0.37,95%CI:0.29～0.49)以及患者年龄(OR=0.74,95%CI:0.61～0.90)显著相关，差异有统计学意义(P <0.05)，而与分化程度、肿瘤直径和患者性别未发现相关性(P>0.05)。结论 SIRT1在胃癌组织中表达显著增加，同时肿瘤呈肠型、浸润深度(T3+T4)、临床分期(Ⅲ+Ⅳ)和伴随淋巴结转移的胃癌组织中SIRT1表达显著增加。SIRT1可能作为新的潜在肿瘤预测因子，对胃癌的早期诊断和预后判断等具有一定的指导意义。

关键词：SIRT1；胃癌；早期诊断；Meta 分析

Abstract：

Objective To explore the relationship between SIRT1 and clinicopathological features of gastric cancer, so as to provide basis for early diagnosis and prognosis evaluation of gastric cancer. Method Published studies about SIRT1 expression and gastric cancer were searched in PubMed, EMBASE, CNKI and Wan Fang databases by two independent researchers from the establishment of the database to June 2021. The Chinese search keywords are "SIRT1, information regulatory factor 1, gastric cancer, clinicopathological features", and the English search keywords are "SIRT1, sirtuin1, genetic carcinoma, genetic cancer, clinicopathological variables". A total of 454 studies were searched in the preliminary screening. After removing 153 duplicate studies, 301 remained, and after removing 281 conference papers, reviews, case reports and animal experimental studies, 20 remained. After reading the full text, 14 studies were finally included in our Meta[1]analysis. The expression of SIRT1 in gastric cancer and normal control tissues and the relationship between SIRT1 expression and clinicopathological characteristics of gastric cancer, such as differentiation and depth of invasion were analyzed. After study selection and data extraction, the Meta -analysis was conducted using STATA16.0 software. Odds ratio （OR） with 95% confidence interval （CI） was used to estimate the pooled effect. Egger’s test and Begg’s funnel were used to assess publication bias. Two-tailed P≤0.05 was regarded as statistically significant. Result According to the inclusion and exclusion criteria,12 studies were enrolled, including 2228 cases of gastric cancer and 550 adjacent tumor tissue or normal controls. Results of the meta[1]analysis indicated that the SIRT1 expression was significantly higher in esophageal carcinoma than that in cancer adjacent tissue or normal control （OR=6.84，95%CI：3.92-11.93）, P<0.05. The relationship between SIRT1 and clinicopathological characteristics of gastric cancer showed that SIRT1 expression in gastric cancer patients with classification （Intestinal vs. Diffuse） （OR=1.88，95%CI：1.08 -3.29）, infiltration（T1+T2）vs.（T3+T4）（OR=0.44, 95%CI：0.24 -0.80）, TNM stage （Ⅰ+Ⅱ） vs. （Ⅲ+Ⅳ） （OR=0.51，95%CI：0.33-0.79）, lymph node metastasis negative vs. positive （OR=0.37，95%CI：0.29-0.49） and age （<60） vs. （≥60）OR=0.74，95% CI：0.61 -0.90）, P <0.05. No significant difference of SIRT1 expression was observed in differentiation, tumor size and gender of patients with gastric cancer （P>0.05）. Conclusion SIRT1 overexpressed in gastric cancer, and the expression of SIRT1 was closely related to the invasion and metastasis of gastric cancer. It might be a potential biomarker to identify the progress of gastric cancer.

Key Words: SIRT1；Gastric cancer；Early diagnosis；Meta-analysis