| Objective:Colorectal cancer(CRC)is one of the common types of gastrointestinal malignant tumors,it's prognosis is influenced by many elements.The impact of miRNA-21 on the prognosis of patients in colorectal cancer is still controversial.The research conducts a meta-analysis about the relationship between miRNA-21 and prognostic value in colorectal cancer,which mainly adopts the method of evidence-based medicine,providing an evidence-based medical evidence for clinical diagnosis and treatment.Methods:According to the type,the object and the purpose of this research,we conducted an appropriate inclusion and exclusion criteria and detailed retrieval strategy.through the computer we made a systematic retrieval in the PubMed,EBSCO full text database,the Cochrane library,Medline,EMBASE,China academic journal full-text database(CNKI),Wanfang database,science citation index database,Chinese biomedical literature database,VIP databases,etc.from the time of the database construction to March 2017 in published relevant literature,The Newcastle-Ottawa Scale(NOS)was used to assess the quality of the eligible literature.Building an Excel spreadsheets to collect relevant data,Statistical analysis was performed by the RevMan 5.3 software of Cochrane Collaboration,The pooled survival analysis effect was denoted by the hazard ratio(HR),the evaluation of statistically significant with the 95% confidence interval(CI),The outcomes were described by Forest plot and Funnel plot.Statistical analysis was performed by the STATA 12.0software to assess publication bias with Egger's and Begg's test,the publication bias exists if the asymmetry of funnel figure or the P value of the Egger linear regression method isless than 0.1.Results:Eventually 18 research literatures were included,a total of 4394 patients in colorectal cancer.of which 15 articles were related to the relationship between miRNA-21 in organization and the prognosis of the patients in colorectal cancer,3 studies covered miRNA-21 in the blood,Seven articles provides the relationship between miRNA-21 and the Disease-free Survival(DFS),13 articles is given the relationship between miRNA-21 and the Overall Survival(OS).The results of this Meta-analysis showed that 1.ten studies involving ten groups,were related to the relationship between the expression of miRNA-21 in tissue and OS of the patients in colorectal cancer,the pooled HR = 2.57,95% CI(2.11,3.14),P < 0.00001,the difference was statistically significant.95% CI does not contain 1,and HR > 1,the result hints that the overexpression of tissue miRNA-21 were significantly correlated with OS in postoperative patients with colorectal cancer,the overexpression of miRNA-21 is 2.57 times than the patients with no-overexpression of miRNA-21 in poor OS,and illustrates the miRNA-21 is adverse factors for the prognosis of patients in colorectal cancer;2.There were 7 studies which were based on the analysis of the relationship between the expression of tissue miRNA-21 and the DFS in patients with colorectal cancer;the combined effect of HR = 1.49,95% CI(1.33,1.68),P < 0.00001).95% CI does not contain1,and HR > 1,prompting the overexpression of tissue miRNA-21 in patients with colorectal cancer have shorter DFS,the overexpression of miRNA-21 is 1.49 times than the patients with no-overexpression of miRNA-21 in poor DFS;3.only 3 studies were involved in the pertinence between the expression of blood miRNA-21 and its prognosis in patients with colorectal cancer,the three researches are all related to the OS,and heterogeneity is high,the combined effect is adopted by random effects model,HR = 1.33,95% CI(0.44,4.02),P = 0.61,there was no statistically significant difference.Hint of the expression of the blood miRNA-21 has no obvious correlation with OS in postoperative patients with colorectal cancer.Conclusion:1,The prognosis of CRC is influenced by many factors,the overexpression of miRNA-21 is poor prognosis in CRC;2,miRNA-21 can be used as a new direction of the future treatment of CRC,providing a potential target for targeted therapy of CRC;3,This study can not completely avoid the existence of bias,more high quality clinical research should involve to verify the results. |
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