| Objective:Leptin is closely related to the proliferation and apoptosis of tumor cells,but the results of the clinical significance of leptin in gastric cancer are still controversial.This study used a meta-analysis method to systematically explore the expression of leptin in gastric cancer and its relationship with clinicopathological features.Method: Computer search PubMed,Web of Science,EMbase,Cochrane Library.After screening the literature based on inclusion and exclusion criteria,the literature used pre-established data extraction tables to collect data and evaluate its methodological quality using the NOS scale.statistical analysis was performed using professional statistical software Stata 12.0 and RevMan 5.3,and the odds ratio(OR)and its 95% confidence interval(95% CI)were used to evaluate the effect size of the study indicators.Subgroup analysis and sensitivity analysis were used to further investigate factors that may influence the results of the analysis,while using Stata to create a funnel plot to test publication bias.Results:A total of 12 observational studies(1524 patients)were screened by literature search,and the quality of each study was good.Meta-analysis showed that leptin had low expression in gastric cancer tissues relative to normal tissues [SMD =-1.43,95% CI(-2.4.-0.47),P=0.004];leptin expression levels in gastric cancer patients with lymphatic metastasis were lower than patients without lymphatic metastasis [OR=0.53,95% CI(0.35.-0.81),P=0.004].There was no difference in the expression of leptin between male and female gastric cancers [OR=0.55,95% CI(0.06-4.72),P=0.58];the expression of leptin was not different in the gastric cancer patients of the age group of 45 years old [OR=0.89 95% CI(0.30.-2.62),P =0.83];the expression level of leptin was not different in gastric cancer patients with tumor diameter of 5 cm [OR=1.14,95% CI(0.71.-1.85),P=0.59];The expression of leptin was not significantly different in patients with high and low differentiation gastric cancer [OR=1.49,95%CI(0.05-4.05),P=0.43];the expression level of leptin was stage I-II and III-IV in TNM stage.There was no difference in the expression of gastric cancer patients [OR=0.51,95% CI(0.19-1.38),P=0.18],but in patients who had not received treatment,the positive expression of leptin in stage I and II was lower than III.Stage IV,and the difference was statistically significant [OR=0.35,95% CI(0.17-0.71),P=0.004].The expression level of leptin was not different in gastric cancer patients who passed through the serosa [OR=1.08,95% CI(0.44.-2.7),P =0.86].Subgroup analyses indicate whether patients receiving treatment can explain the source of heterogeneity.Conclusion: The expression level of leptin inpatients with gastric cancer was lower than that in patients with non-gastric cancer,and in patients with lymphoid metastasis was lower than that in patients without lymphoid metastasis.The low expression of leptin could be used as an index to reflect the poor prognosis of patients,and most of them were caused by cachexia.The positive degree of leptin expression in TNM stage?and II was lower than that in TNM stage III and IV without treatment.A multi-center,.prospective randomized controlled trial was still needed in the mechanism of leptin in gastric cancer. |
PDF Full Text Request