Protein Markers Of Radiosensitivity Of Nasopharyngeal Carcinoma In Chinese：Meta-analysis

Background: The incidence of NPC in China accounted for about80%of the world,especially in Guangdong, Guangxi and other south-eastern region, the mortality rate accounted for2.81%of all cancer mortality, ranking eighth place. Radiotherapy is the primary therapy ofnasopharyngeal carcinoma, however local recurrence and distant metastasis is the main reason fortreatment failure, mainly due to intrinsic radiosensitivity of tumor. The protein markers ofradiation sensitivity include cell cycle regulation, DNA damage repair, apoptosis,angiogenesis-related protein. The clinical studies on protein markers of radiation sensitivity arealmost retrospective case studies, but the results of each study are various, currently there is nometa-analysis about this aspect.Methods: We identified potential studies by searching Pubmed and CNKI datebases(from1977to March2013)and by reviewing the reference list of pertinent publications.Studies wereeligible for inclusion if they met the following criteria:(1) research object:①All the cases werepreviously untreated patients, race for the Chinese people;②nasopharyngeal carcinoma isconfirmed by pathological examination;(2) interventions: radiotherapy;(3) have exact efficacyindicators.Results: A total of96studies including12kinds of proteins,especially the protein p53、Cyclin D1、 PCNA、 Ki-67and Survivin have both short-term and long-term efficacyindicators.The NPC patients with p53highly expressed after radical radiotherapy had lower rate ofcomplete remission(CR)(OR=0.672（95%CI：0.455~0.992），P=0.046) and lower5-year overallsurvival rate (5OS)(OR=2.488（94%CI：1.749~3.539），P=0.000); The NPC patients with CyclinD1highly expressed after radiotherapy had lower5OS (OR=3.950(94%CI:1.638to9.524), P=0.002)，although CR was not significantly associated statistically（OR=0.575（95%CI：0.085~3.882），P=0.570）; The NPC patients with PCNA highly expression had lower CR rate(OR=0.347（95%CI：0.212~0.566）， P=0.000) and lower5OS (OR=2.564（95%CI：1.176~5.591），P=0.018); The NPC patients with Ki-67highly expression had the higher CR rateafter radical radiotherapy (OR=5.597(95%CI:3.276to9.561), P=0.000),and lower5OS (OR=2.747(95%CI:1.592to4.740), P=0.000); The NPC patients with Survivin highly expressionafter radical radiotherapy had lower CR rate (OR=0.208(95%CI:0.112to0.386), P=0.000),and lower5OS (OR=2.709(95%CI:1.974to3.716), P=0.000). Conclusions: Higher p53, PCNA and Survivin expression was significantly associated withlower CR rate and5OS of The NPC patients after radiotherapy,while Ki-67highly expression hadthe higher CR and lower5OS.NPC patients had combined detection of protein markers beforeradiotherapy can make individualized radiation therapy project.