CAJ | 학술논문

目的：采用系统评价及meta分析方法评价DNMT3 A基因突变与急性髓系白血病（ AML）预后间的关联。方法：采用Cochrane 系统评价方法体系，计算机检索PubMed、Embase数据库、Ovid、中国知网、中国生物医学文献数据库、万方和维普等数据库收集关于DNMT3A基因突变对AML预后影响的文献，并手工检索纳入文献的参考文献。筛选相关文献，对纳入文献评价方法学质量，提取临床对照试验数据，采用Stata 11.0软件进行meta分析。结果：本研究共纳入7个临床对照试验，合计1493例研究对象。 Meta分析结果显示DNMT3 A基因突变患者与无DNMT3 A基因突变患者比较，两组完全缓解率差异无统计学意义（ OR＝1.034，P＝0.905，95％CI：0.596～1.796），但DNMT3 A基因突变患者无病生存期（ HR＝2.84， P＝0.002，95％CI：1.063～4.613）和总生存期（ HR ＝1.99， P＝0.000，95％CI：1.463～2.510）均较无DNMT3 A基因突变患者缩短。结论：DNMT3 A基因突变是AML患者预后不良的一个独立危险因素。
목적：채용계통평개급meta분석방법평개DNMT3 A기인돌변여급성수계백혈병（ AML）예후간적관련。방법：채용Cochrane 계통평개방법체계，계산궤검색PubMed、Embase수거고、Ovid、중국지망、중국생물의학문헌수거고、만방화유보등수거고수집관우DNMT3A기인돌변대AML예후영향적문헌，병수공검색납입문헌적삼고문헌。사선상관문헌，대납입문헌평개방법학질량，제취림상대조시험수거，채용Stata 11.0연건진행meta분석。결과：본연구공납입7개림상대조시험，합계1493례연구대상。 Meta분석결과현시DNMT3 A기인돌변환자여무DNMT3 A기인돌변환자비교，량조완전완해솔차이무통계학의의（ OR＝1.034，P＝0.905，95％CI：0.596～1.796），단DNMT3 A기인돌변환자무병생존기（ HR＝2.84， P＝0.002，95％CI：1.063～4.613）화총생존기（ HR ＝1.99， P＝0.000，95％CI：1.463～2.510）균교무DNMT3 A기인돌변환자축단。결론：DNMT3 A기인돌변시AML환자예후불량적일개독립위험인소。
Objective: To evaluate the effects of DNMT3A gene mutation on prognosis of patients with acute myeloid leukemia ( AML ) by a meta-analysis. Methods: Methods of Cochrane systematic review was followed by 7 databases , including PubMed, Embase, Ovid, CNKI, CBM, WanFang Data and VIP, were searched for peer-reviewed articles related to DNMT3A gene mutations and prognosis of patients with AML .Then manual retrieval was applied into literature references .After the evaluation of quality and extract of clinical trialliterature data , Stata 11 .0 was employed to perform meta-analysis.Results: Seven randomized controlled trials involving 1493 cases were included in the meta-analysis .The prognosis of patients with DNMT3A mutations and without DNMT3A mutations was compared .There was no statistically significant difference in complete remission ( CR) rate ( OR=1.034, 95%CI:0 .596 ~1 .796 , P=0 .905 ) between two groups , but the overall survival ( OS ) (HR=1.990, 95%CI:1.463~2.510, P=0.000)and disease free survival (DFS) (HR=2.840, 95%CI :1.063 ~4.613, P=0.002,) of patients without DNMT3A mutations were longer than those with DNMT3A mutation.Conclusion: DNMT3A gene mutation is an independent risk factor of poor prognosis of patients with acute myeloid leukemia .