| Objective:Digestive system cancers has played an important role in threatening human survival and health,so it is worth to find sensitive and effective adjuvant therapeutic target to improve outcome and prolong survival of patients with digestive system cancers.The research found that there was dramatically related between signal transducer and activator of transcription 3(STAT3)and activated state phosphorylated-STAT3(pSTAT3)and the development of digestive system malignant tumors.However,the significance of the expression levels of STAT3 and pSTAT3 in tumor tissues on tumor staging and prognosis of patients has not been deeply clarified.A meta-analysis was conducted to explore the relationship between the expression level of STAT3/pSTAT3 in tissue samples from patients with cancers of the digestive system and clinical pathological features and prognosis of patients and make it clear,then to highlight the significance of STAT3/pSTAT3 as a biomarker and target treatment.Method : By searching Pubmed,Embase and Cochrane Library,the studies discussing on the expression level of STAT3 and pSTAT3 in digestive system cancers and its clinical predictive significance were collected from January 1,2000 to June 26,2018.According to the inclusion and exclusion criteria,all of these works containing literature screening,data extraction,and literature quality evaluation were completed,and relevant data were analyzed using STATA 12.0 software.The hazard ratio(HR)and the 95% confidence interval(CI)were used to analyze the survival data,the odds ratio(OR)and 95% confidence interval(CI)were used to analyze the clinicopathological parameters.When the heterogeneity of the combined results is small,the fixed effect model is used;otherwise,the random effect model is used.To further explore the source of heterogeneity,it is necessary to use subgroup analysis and sensitivity analysis methods.Begg's funnel plot was used to detect the publication bias of the results.Result:Based on the above mentioned,60 studies were finally included,26 gastric cancers,23 colorectal cancers,5 liver cancers,3 pancreatic cancers,and 3 esophageal cancers,total 8111 patients.Meta-analysis showed that increased expression of STAT3 and pSTAT3 was markedly associated with decreased overall survival and disease-free survival(overall survival: HR=1.739,P<0.001;disease-free survival: HR=2.10,P<0.001).In the specimens of digestive system cancers,the expression of STAT3/pSTAT3 was notably higher in the poorly differentiation than the moderately and highly differentiation(OR=1.352,P=0.028).The expression of STAT3/pSTAT3 in the patients with later stage was higher than earlier stage(OR=0.687,P=0.014);the expression of STAT3/pSTAT3 in the patients with deeper primary tumor infiltration was higher(OR=1.751,P=0.007);the expression of STAT3/pSTAT3 in the patients with lymph node metastasis was significantly higher than that without lymph node metastasis(OR=1.738,P<0.001).At the same time,the degree of lymphatic invasion was significantly correlated with the increase of STAT3/pSTAT3 expression(OR=2.791,P=0.001).However,there was no statistical difference between venous invasion,perineural invasion,distant metastasis,and gender and STAT3/pSTAT3 expression.Conclusions:The expression level of STAT3/pSTAT3 in specimens of digestive system cancers is closely related to many clinicopathological parameters and prognosis.The expression level of STAT3/pSTAT3 is of great value for adjuvant therapy and prognosis.These articles,included in the research,were mainly from retrospective studies,and more high-quality prospective case-control studies would be needed to further substantiate this view. |
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