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no-repeat 6px;background-position:center;margin-top:10px;min-width:55px;display:none;} @media (min-width:768px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .expand_btn{display:none;}} .hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .caption-text{-webkit-flex:9;-ms-flex:9;flex:9;text-align:left;padding:21px 37px 10px 0px;font-size:16px;font-weight:700;} @media (min-width:768px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .caption-text{padding:19px 18px 10px 18px;}} @media (min-width:992px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .caption-text{padding:19px 21px 10px 21px;}} .hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption 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no-repeat 6px;background-position:center;padding:16px 0 16px 0;min-width:62px;max-width:62px;} @media (min-width:768px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .caption-partial-url{padding:16px 0 17px 0;min-width:52px;max-width:52px;}} @media (min-width:992px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .caption-partial-url{padding:15px 0 17px 0;min-width:60px;max-width:60px;}} .hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption .caption-partial-url:hover{-webkit-text-decoration:none;text-decoration:none;} .hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption-text{font-size:14px;padding:0px 18px 17px 22px;} @media (min-width:768px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption-text{padding:0px 15px 15px 18px;}} @media (min-width:992px){.hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption-text{padding:0px 18px 19px 21px;}} .hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption-text figcaption{margin:0;padding:0;} .hkyIvx .floats-partial-section .floats-partial-footer .floats-partial-caption-text svg{max-width:100%;} .hkyIvx ol{font-size:16px;padding-left:32px;font-family:STIXGeneral-Regular;line-height:24px;margin:15px 0;} .hkyIvx ol li{margin:10px 0;padding-left:10px;word-break:normal;} .hkyIvx ol li a{word-break:break-all;} .hkyIvx ol li .reflinks{display:block;} .hkyIvx ol li .reflinks a{color:#4D8A17;-webkit-text-decoration:none;text-decoration:none;cursor:pointer;} .hkyIvx ol li .reflinks a:hover{-webkit-text-decoration:underline;text-decoration:underline;} .hkyIvx ol li .reflinks .sep{color:#000000;} .hkyIvx .table-wrapper{width:auto;overflow-x:auto;} .hkyIvx .table-wrapper::-webkit-scrollbar{-webkit-appearance:none;width:5px;height:5px;} .hkyIvx .table-wrapper::-webkit-scrollbar-thumb{border-radius:5px;background-color:rgba(0,0,0,.5);-webkit-box-shadow:0 0 1px rgba(255,255,255,.5);} @media (min-width:768px){.hkyIvx .table-wrapper{overflow-x:auto;width:auto;-webkit-break-word:word-break;break-word:word-break;margin:0 auto;}} @media (min-width:992px){.hkyIvx .table-wrapper{width:auto;}} @media (min-width:1324px){.hkyIvx .table-wrapper{width:auto;}} @media (min-width:320px){.hkyIvx{margin-bottom:33px;padding:0;}} @media (min-width:992px){.hkyIvx{padding:0;margin-bottom:100px;}} @media (min-width:1325px){.hkyIvx{margin-bottom:100px;}} .hkyIvx .owl-stage{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;} .hkyIvx .floats-partial-middle--thumbs{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;} .hkyIvx .floats-partial-middle--thumbs .partial-carousel-dot svg{fill:#4D8A17;} .hkyIvx .floats-partial-middle--thumbs .partial-carousel-dot strong{color:#4D8A17;font-weight:500;} .hkyIvx .floats-partial-middle--thumbs .partial-carousel-dot.active strong{color:#007B8B;} .hkyIvx 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class="sc-cooIXK gQxyld">特刊</span> <h2 class="sc-fcdeBU bVtmCk">尿路上皮癌</h2> <a class="sc-htpNat bUhGXt link sc-gmeYpB hSHJbi" href="//www.newsama.com/journals/au/si/957230/" aria-label="">浏览特刊</a> <hr class="sc-clNaTc ktFfKO"> </div> <p class="sc-kZmsYB bkiEfx article_type">审查文章|开放访问</p> <div class="sc-RcBXQ ztvYg article_citation"> 体积 2012年 <span class="sc-fZwumE cUsFHx">|</span>文章的ID 181964 <span class="sc-fZwumE cUsFHx">|</span> <a class="sc-htpNat bUhGXt link sc-fQejPQ duuwge" href="https://doi.org/10.1155/2012/181964" aria-label="Doi-link">https://doi.org/10.1155/2012/181964</a> </div> <div class="sc-LKuAh lcOiDF article_full_citation"> <div class="sc-hzNEM gsmOCv isHide"> <p>玉清·何泰，洪林成，九泉省南山汤， ＂<span class="adjust-article-svg-size">膀胱尿路上皮癌ErbB受体家族的临床意义:系统综述和meta分析</span>"，<i>泌尿外科的进步</i>， 卷。2012年， 文章的ID181964， 11.   页面， 2012年． https://doi.org/10.1155/2012/181964</p> </div> <button class="sc-hSdWYo etauus sc-iBEsjs kPshFw" color="">显示引用</button> </div> <h1 class="sc-iRbamj jZOxOO sc-iSDuPN bDJBEi article_title adjust-article-svg-size heading-title">膀胱尿路上皮癌ErbB受体家族的临床意义:系统综述和meta分析</h1> </div> <div class="sc-jrIrqw eHMFfo article_authors"> <hr class="sc-cEvuZC XkrFe hr__author"> <span class="">Yuh-Shyan蔡，<sup>1</sup></span> <span class="">洪林成，<sup>1</sup></span> <span class=""><b>崇安兴Tzai</b><a class="sc-htpNat bUhGXt link" href="mailto:" aria-label="Mail Option"><span class="sc-htoDjs kNoiZu sc-hjRWVT irNWJI icon-colored _2zt-1j0LmaF8UjTQAM413G icon-themeable" title="" font-size="16"></span></a>，<sup>1，2</sup> 和</span> <span class=""><b>Nan-Haw周润发</b><a class="sc-htpNat bUhGXt link" href="mailto:" aria-label="Mail Option"><span class="sc-htoDjs kNoiZu sc-hjRWVT irNWJI icon-colored _2zt-1j0LmaF8UjTQAM413G icon-themeable" title="" font-size="16"></span></a><sup>3.</sup></span> <div class="sc-fHxwqH dMuGGA isHide"> <p><sup>1</sup><span>泌尿外科，成大医院，台南70403，系台湾</span></p> <p><sup>2</sup><span>泌尿外科，医学院，国立成功大学，台南70403，系台湾</span></p> <p><sup>3.</sup><span>病理学，药学院，成大医院，台南70403，系台湾</span></p> </div> <button class="sc-hSdWYo etauus sc-iQtOjA kfDwZY" color="">展示更多</button> </div> <div class="articleContent__EditorWrapper-sc-2yl9jy-3 evMkvU"> <div class="articleContent__TextWrapper-sc-2yl9jy-8 fYrLtk"> <b>学术编辑器:</b>三位一体J. Bivalacqua</div> <div class="articleContent__PublicationTimeLineWrapper-sc-2yl9jy-4 fjviok"> <div class="articleContent__PublcationCol-sc-2yl9jy-5 hgKieC notPublished"> <span class="articleContent__PublicationField-sc-2yl9jy-6 cIribm">收到了</span> <span class="articleContent__PublicationValue-sc-2yl9jy-7 khHUcu">2012年4月4日</span> </div> <div class="articleContent__PublcationCol-sc-2yl9jy-5 hgKieC notPublished"> <span class="articleContent__PublicationField-sc-2yl9jy-6 cIribm">修改</span> <span class="articleContent__PublicationValue-sc-2yl9jy-7 khHUcu">2012年5月16日</span> </div> <div class="articleContent__PublcationCol-sc-2yl9jy-5 hgKieC notPublished"> <span class="articleContent__PublicationField-sc-2yl9jy-6 cIribm">接受</span> <span class="articleContent__PublicationValue-sc-2yl9jy-7 khHUcu">2012年5月16日</span> </div> <div class="articleContent__PublcationCol-sc-2yl9jy-5 hgKieC isPublished"> <span class="articleContent__PublicationField-sc-2yl9jy-6 cIribm">发表</span> <span class="articleContent__PublicationValue-sc-2yl9jy-7 khHUcu">2012年9月9日</span> </div> </div> </div> <article class="sc-jtRlXQ hkyIvx article_body "> <div> <div class="xml-content"> <h4 class="header" id="abstract">抽象的</h4> <p>人膀胱癌检查ErbB受体家族表达的预后重要性仍然不明朗。使用公布的证据，我们检查的临床应用价值和临床试验靶向ErbB受体家族成员的更新的结果。从与膀胱癌ErbB受体表达评估65个引用二十七个条款进行了审查。估计包括所述关联的意义，风险比，并从精算曲线和存活分析的95个％置信区间（CI）。一项荟萃分析，使用单变量数秩检验或考克斯回归模型这些报告完成。选择的分析和研究对象的方法，研究差异很大。疾病进展的患者的EGFR或ErbB2过表达的总风险是4.5（95％CI：2.5-8.4）和1.1（95％CI：0.6-1.9），和死亡率的风险是3.0（95％CI：1.6-5.9）和1.1（95％CI：1.0-1.2），分别。然而，ErbB受体家族共表达模式的意义仍存在争议。六个临床试验没有得到令人信服的结果为在尿路上皮癌封锁ErbB受体信号传导。这一分析的结果表明，ErbB家族的评估共表达模式可能为膀胱癌患者更好的预后信息。</p> <span class="end-abs"></span> <h4 id="introduction">1.介绍</h4> <p>膀胱癌的特征之一是它的可变患者的预后。约的浅70％（Ta和T1）的肿瘤复发，以及它们中的10-20％变为侵入性[<a href="#B1">1</a>］．肿瘤是侵入性的，在初步诊断携带进展尽管根治性膀胱切除等辅助疗法的高风险。传统的预后因素，如肿瘤分期，分级，大小，多灶性，不准确预测临床结果对某些病人。因此，已经进行了大量的努力，以确定用于预测疾病进展，对治疗的反应，和长期生存的机会的生物标志物。目前，建议的膀胱癌患者有定期尿脱落细胞学，膀胱镜检查，并在后续的成像研究[<a href="#B2">2</a>］．</p> <p>ERBB受体家族（也称为表皮生长因子受体（EGFR）家族）是受体酪氨酸激酶（RTK）原毒细胞的主要类别。它们在许多细胞调节过程中是重要的，例如增殖，迁移，粘附，并且可能，细胞转化，包括尿路上皮发生。erbb家族由4名成员组成：erbb1（也称为EGFR和HER1），ERBB2（C-<i>erb</i>b - 2和HER2 /<i>neu</i>），ErbB3的（HER3），和ErbB4（HER4）。二聚化通过结合两种单体是用于激活的RTK [调节机制<a href="#B3">3.</a>］．在一些情况下，异源二聚体复合物的形成允许相同亚科不同受体之间的相互作用和串扰，和ErbB受体家族的是均聚物和异二聚化的最好例子<i>体内</i>［<a href="#B4">4</a>，<a href="#B5">5</a>］．因此，阐明ERBB表达的临床意义可以为癌症治疗提供重要的分子靶标。</p> <p>EGFR信号传导调节人类癌症，包括肺癌，乳腺癌，和前列腺癌[发病机制中重要的生物学过程<a href="#B6">6</a>］．在实践中，针对原发肿瘤中EGFR基因突变的治疗扩展了靶向癌症治疗的主题[<a href="#B7">7</a>］．在乳腺癌中，HER2扩增状态是预测化疗反应的枢转生物标志物[<a href="#B8">8</a>]，和人源化抗HER2单克隆抗体（曲妥单抗）提高HER2阳性乳腺癌患者的存活[<a href="#B9">9</a>］．ErbB受体信号转导的预后意义具有组织特异性。例如，EGFR/HER2- mapk轴在人类乳腺癌中很重要，而HER2/ErbB3轴的激酶活性在前列腺癌的DNA结合和雄激素受体稳定性中起着主要作用[<a href="#B10">10.</a>］．此外，EGFR抑制剂吉非替尼对激素难治性前列腺癌无效，这一结果质疑了EGFR/HER2轴在前列腺癌分子发病机制中的意义[<a href="#B11">11.</a>］．</p> <p>建立膀胱癌ErbB受体家族成员的临床意义，我们系统回顾发表在ErbB受体家族的表达在过去二十年的论文，成员或共表达模式的任何一个，以及它们对患者的预后影响。我们的目标是确认ErbB受体表达的意义在膀胱癌患者预测复发，进展和死亡率，找出可能影响ErbB受体的预后评估，并进行可估计的荟萃分析的因素。此外，我们评估异质矛盾的结果基本的潜在来源，并且结合的定量方法对数据进行分析。临床试验的靶向ErbB受体信号传导的更新的结果也进行了审查。</p> <h4 id="materials-and-methods">2。材料和方法</h4> <h5 id="sec2.1">2．1.搜索策略和选择标准</h5> <p>本文系统回顾了1985年1月至2011年5月发表的关于膀胱癌患者中ErbB受体成员表达或扩增的预后意义的原始文章。使用关键词“EGF”、“EGF- r”、“c- erbb - b1”、“c- erbb - b2”、“c- erbb - b3”、“c- erbb - b4”、“neu”、“表皮生长因子”和“人膀胱肿瘤或移行细胞癌”，我们在PubMed数据库中找到了710篇相关文章。通过限制对“预后”或“生存”(包括疾病复发和进展)的研究，研究数量减少到65项。通过回顾研究者、患者来源、招募时期或纳入标准的研究间相似性，在同一队列中发现的重复数据，被排除在当前的分析之外。我们的分析只包括最大的系列。</p> <h5 id="sec2.2">2.2。数据抽取，处理，分析</h5> <p>我们的数据库旨在确保基于研究设计，患者结果，肿瘤特性，统计分析，生物样品，分析方法（即，免疫组化[IHC]，荧光原位杂交[鱼]，以及原位杂交[鱼]的荧光，以及真实的相关数据的广度- 偶联聚合酶链反应[RT-PCR]，以及ERBB受体家族成员的过表达或基因扩增的发生率。</p> <p>用两种方法总结结果。因为大多数文章只提供<svg height="10.325" id="M1" style="vertical-align:-0.0pt;width:11.75px;" version="1.1" viewbox="0 0 11.75 10.325" width="11.75" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.325)"> <g transform="translate(72,-63.74)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> </g> </g> </svg>结果是否显著(且无其他效果度量)的值或声明，复发、进展、死亡率、无进展生存期、无病生存期以及化疗和放疗耐药性的分析均基于原始报告中的定义。简单地说，复发被定义为肿瘤在非高T期的膀胱中重新出现，而疾病进展被定义为任何肿瘤在局部肿瘤、淋巴结或转移中具有高T期。的<svg height="10.325" id="M2" style="vertical-align:-0.0pt;width:11.75px;" version="1.1" viewbox="0 0 11.75 10.325" width="11.75" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.325)"> <g transform="translate(72,-63.74)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> </g> </g> </svg>从关联分析(<svg height="16.924999" id="M3" style="vertical-align:-2.53308pt;width:16.924999px;" version="1.1" viewbox="0 0 16.924999 16.924999" width="16.924999" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,16.925)"> <g transform="translate(72,-58.46)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> <text transform="matrix(1,0,0,-1,-63.39,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</T.span> </text> </g> </g> </svg>Fisher的精确测试，学生的<i>T.</i>-test，曼 - 惠特尼<svg height="10.5375" id="M4" style="vertical-align:-0.16302pt;width:12.8625px;" version="1.1" viewbox="0 0 12.8625 10.5375" width="12.8625" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.5375)"> <g transform="translate(72,-63.57)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> </g> </g> </svg>单变量(Kaplan-Meier曲线和log-rank检验)和多变量生存(Cox回归)分析的风险估计和95%置信区间(CIs)。通过提供带有标准差(SD)或范围的百分比平均值或实际数字来总结数据。<svg height="16.924999" id="M5" style="vertical-align:-2.53308pt;width:16.924999px;" version="1.1" viewbox="0 0 16.924999 16.924999" width="16.924999" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,16.925)"> <g transform="translate(72,-58.46)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> <text transform="matrix(1,0,0,-1,-63.39,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</T.span> </text> </g> </g> </svg>在适当的情况下，使用测试和费舍尔的确切测试来评估两个分类变量的独立性。无条件的逻辑回归模型用于确定研究特征的重要性（<svg height="11.25" id="M6" style="vertical-align:-0.30096pt;width:63.650002px;" version="1.1" viewbox="0 0 63.650002 11.25" width="63.650002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.25)"> <g transform="translate(72,-63)"> <text transform="matrix(1,0,0,-1,-71.95,63.35)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> <</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="31.957668" y="0"> ⋅</T.span> <tspan style="font-size: 12.50px; " x="38.309193" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="44.560692" y="0"> 5</T.span> </text> </g> </g> </svg>）。</p> <p>使用多变量测试的荟萃分析，然后完成。用狼的方法运用方差的倒数作为权重因子的风险评估结合起来。使用图形方法，如Galbraith图异质的潜在来源进行了研究。据统计异质性测试，在所有荟萃分析完成。异质性被认为是显著时<svg height="11.0625" id="M7" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.0625" width="56.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.0625)"> <g transform="translate(72,-63.15)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> <</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 1</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 0</T.span> </text> </g> </g> </svg>．在异质性较大的情况下，采用随机效应模型。综合风险估计受个体研究影响的程度通过在荟萃分析中连续省略每一项研究来检验。使用元回归来解释来自相同特征的潜在异质性<svg height="10.325" id="M8" style="vertical-align:-0.0pt;width:11.75px;" version="1.1" viewbox="0 0 11.75 10.325" width="11.75" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.325)"> <g transform="translate(72,-63.74)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> </g> </g> </svg>价值分析。使用艾格的和贝格的图形化方法的发表偏倚进行了研究。该分析采用综合的Meta分析第2版（的Biostat，恩格尔伍德，NJ，USA）完成。意义定为<svg height="11.25" id="M9" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.25)"> <g transform="translate(72,-63)"> <text transform="matrix(1,0,0,-1,-71.95,63.35)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> <</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 5</T.span> </text> </g> </g> </svg>（双面）。</p> <h4 id="results">结果</h4> <h5 id="sec3.1">3．1.单个ErbB受体表达的意义</h5> <p>在1233名复发患者在16个分析肿瘤报道8个研究（中位数：162例;范围：52-243）（表<a href="//www.newsama.com/journals/au/2012/181964/tab1/" target="_blank">1</a>）[<a href="#B5">5</a>，<a href="#B16">12.</a>- - - - - -<a href="#B14">18.</a>］．在频率的顺序分析的受体成员的ErbB2（8 7）和EGFR（8 6）。三项研究[<a href="#B5">5</a>，<a href="#B12">15.</a>，<a href="#B18">16.</a>]报告了显著的积极结果。数据处理后，只有4份报告被接受分析:2份EGFR报告和2份ErbB2报告(图)<a href="//www.newsama.com/journals/au/2012/181964/fig1/" target="_blank">1(一)</a>）。肿瘤阶段的癌症患者的分布变化很大。这四个研究使用IHC来分析他们的研究样本。总体而言，肿瘤复发的风险比为1.588（95％CI：0.9-2.7）。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab1"> <div class="floats-partial-content fig-content-tab1"> <table class="table-group" id="tab1"> <tbody> <tr> <td> <table class="table"> <tbody> <tr> <td class="thead-hr" colspan="5"> <hr></td> </tr> <tr class="thead"> <td align="left">研究名称</T.d> <td align="center">方法</T.d> <td align="center">积分没有。</T.d> <td align="center">研究主题</T.d> <td align="center">意义</T.d> </tr> <tr> <td class="thead-hr" colspan="5"> <hr></td> </tr> <tr> <td align="left">EGFR.</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B16">12.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">230.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B17">13.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">73.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B13">14.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">141.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B12">15.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">52.</T.d> <td align="center">T0-1</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B18">16.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">182.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B5">5</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">245.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left" colspan="5"> <hr></td> </tr> <tr> <td align="left">ErbB2</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B18">16.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">182.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B16">12.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">230.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B17">13.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">55.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B13">14.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">141.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B15">17.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">62.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B14">18.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">248.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B5">5</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">245.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left" colspan="5"> <hr></td> </tr> <tr> <td align="left">ErB3</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B18">16.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">128.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B5">5</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">245.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left" colspan="5"> <hr></td> </tr> <tr> <td align="left">ErbB4</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B18">16.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">124.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr class="table-tr"> <td colspan="5"> <hr class="tbody-hr"></td> </tr> </tbody> </table></td> </tr> <tr class="table-fn"> <td>IHC：免疫组化。<br></td> </tr> </tbody> </table> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表格1</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/tab1/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> ErbB受体家族作为肿瘤复发标志物的意义</div> </div> </div> <div class="floats-partial-section partial-carousel-wrapper" data-section="fig1"> <div class="floats-partial-content fig-content-fig1"> <div class="partial-carousel--single-image"> <img alt="的（a）膀胱癌复发＂name="181964.fig.001a" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.001a.jpg"> <br> <strong>的（a）膀胱癌复发</strong> </div> <div class="partial-carousel--single-image"> <img alt="（b）中膀胱癌进展（EGFR）＂name="181964.fig.001b" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.001b.jpg"> <br> <strong>（b）中膀胱癌进展（EGFR）</strong> </div> </div> <div class="floats-partial-middle"> <div class="floats-partial-middle--thumbs fig-thumbs-fig1"> <button class="partial-carousel-dot" aria-label="(a) Bladder cancer recurrence"><img alt="的（a）膀胱癌复发＂name="181964.fig.001a" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.001a.jpg"><br><strong>的（a）膀胱癌复发</strong></button> <button class="partial-carousel-dot" aria-label="(b) Bladder cancer progression (EGFR)"><img alt="（b）中膀胱癌进展（EGFR）＂name="181964.fig.001b" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.001b.jpg"><br><strong>（b）中膀胱癌进展（EGFR）</strong></button> </div> <div class="partial-carousel-next-prev fig-nav-fig1"> <button class="carousel-prev" aria-label="Previous"></button> <button class="carousel-next" aria-label="Next"></button> </div> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">图1</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/fig1/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> <table> 对EGFR的预后意义和ErbB2过度表达在膀胱癌研究的森林图。（a）关于复发的影响。（b）中EGFR（A）或ErbB2（B）的上进展的影响。风险比和95％（置信区间）顺式对患者要么EGFR-或ErbB2阳性肿瘤。</T.able> </div> </div> </div> <p>在癌症进展方面，8项研究报告了9项分析中的484例患者(中位:60例患者;范围:21 - 113)(表<a href="//www.newsama.com/journals/au/2012/181964/tab2/" target="_blank">2</a>）[<a href="#B12">15.</a>，<a href="#B20">19.</a>- - - - - -<a href="#B24">24.</a>］．按频率顺序分析的受体构件是ERBB2（5 of 8）和EGFR（共8个）。四项研究[<a href="#B12">15.</a>，<a href="#B20">19.</a>，<a href="#B19">20.</a>，<a href="#B22">22.</a>]研究发现显著积极成果。数据处理后，只有4对EGFR报告和3上的ErbB2被接受用于分析（图<a href="//www.newsama.com/journals/au/2012/181964/fig1/" target="_blank">1 (b)</a>）。肿瘤分期的分布变化很大。这四个研究使用IHC来分析他们的研究样本。总体而言，癌症进展的风险比为4.611（95％CI：2.5-8.4），用于EGFR和1.067（95％CI：0.59-1.97）和ErbB2过表达。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab2"> <div class="floats-partial-content fig-content-tab2"> <table class="table-group" id="tab2"> <tbody> <tr> <td> <table class="table"> <tbody> <tr> <td class="thead-hr" colspan="5"> <hr></td> </tr> <tr class="thead"> <td align="left">研究名称</T.d> <td align="center">方法</T.d> <td align="center">积分没有。</T.d> <td align="center">研究主题</T.d> <td align="center">意义</T.d> </tr> <tr> <td class="thead-hr" colspan="5"> <hr></td> </tr> <tr> <td align="left">EGFR.</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B20">19.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">57.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B17">13.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">73.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B12">15.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">52.</T.d> <td align="center">T0-1</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B19">20.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">113.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left" colspan="5"> <hr></td> </tr> <tr> <td align="left">ErbB2</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B21">21.</a>］</T.d> <td align="center">鱼</T.d> <td align="center">62.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B17">13.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">55.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B22">22.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">39.</T.d> <td align="center">T3-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B23">23.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">21.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B24">24.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">67.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr class="table-tr"> <td colspan="5"> <hr class="tbody-hr"></td> </tr> </tbody> </table></td> </tr> </tbody> </table> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表2.</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/tab2/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> ERBB受体家族作为癌症进展标志物的意义。</div> </div> </div> <p>在20项研究中报道了3444例分析患者的癌症相关的死亡率（中位数：88名患者，范围：39-1500）（表<a href="//www.newsama.com/journals/au/2012/181964/tab3/" target="_blank">3.</a>）[<a href="#B5">5</a>，<a href="#B17">13.</a>，<a href="#B12">15.</a>，<a href="#B18">16.</a>，<a href="#B20">19.</a>- - - - - -<a href="#B27">27.</a>，<a href="#B28">34.</a>- - - - - -<a href="#B31">37.</a>］．按频率顺序分析的受体构件是ERBB2（18个，共20个）和EGFR 8的20）。十三个研究[<a href="#B5">5</a>，<a href="#B17">13.</a>，<a href="#B12">15.</a>，<a href="#B18">16.</a>，<a href="#B21">21.</a>- - - - - -<a href="#B23">23.</a>，<a href="#B26">26.</a>，<a href="#B28">34.</a>- - - - - -<a href="#B31">37.</a>]报告了显著的积极结果。在数据处理之后，仅接受EGFR和ERBB2上的10个报告进行分析（图<a href="//www.newsama.com/journals/au/2012/181964/fig2/" target="_blank">2</a>）。肿瘤分期的分布也变化很大。IHC是评估的最常用的方法;然而，鱼肉中1项研究中使用，而在另一个使用基因拷贝扩增。总体而言，癌症死亡的风险比为3.044（95％CI：1.6-5.9），用于EGFR和1.090（95％CI：1.0-1.2），用于ErbB2的过度表达。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab3"> <div class="floats-partial-content fig-content-tab3"> <table class="table-group" id="tab3"> <tbody> <tr> <td> <table class="table"> <tbody> <tr> <td class="thead-hr" colspan="5"> <hr></td> </tr> <tr class="thead"> <td align="left">研究名称</T.d> <td align="center">方法</T.d> <td align="center">积分没有。</T.d> <td align="center">研究主题</T.d> <td align="center">意义</T.d> </tr> <tr> <td class="thead-hr" colspan="5"> <hr></td> </tr> <tr> <td align="left">EGFR.</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B17">13.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">73.</T.d> <td align="center">T2-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B25">25.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">109.</T.d> <td align="center">T2.</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B18">16.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">182.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B26">26.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">59.</T.d> <td align="center">T2-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B27">27.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">141.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left" rowspan="2"> [<a href="#B12">15.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">52.</T.d> <td align="center">T0-1</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="center">IHC.</T.d> <td align="center">101.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B26">26.</a>］</T.d> <td align="center">RT-PCR.</T.d> <td align="center">59.</T.d> <td align="center">T2-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B32">28.</a>］</T.d> <td align="center">RT-PCR.</T.d> <td align="center">88.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B65">29.</a>］</T.d> <td align="center">中存在</T.d> <td align="center">73.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left" colspan="5"> <hr></td> </tr> <tr> <td align="left">ErbB2</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left"> [<a href="#B66">30.</a>］</T.d> <td align="center">基因扩增</T.d> <td align="center">163.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B67">31.</a>］</T.d> <td align="center">基因扩增</T.d> <td align="center">57.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B21">21.</a>］</T.d> <td align="center">鱼</T.d> <td align="center">62.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B68">32.</a>］</T.d> <td align="center">鱼</T.d> <td align="center">1500</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B17">13.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">55.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B22">22.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">39.</T.d> <td align="center">T3-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B25">25.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">109.</T.d> <td align="center">T2.</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B69">33.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">80</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B18">16.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">184.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B28">34.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">90.</T.d> <td align="center">T2-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B29">35.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">138.</T.d> <td align="center">T2-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B30">36.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">132.</T.d> <td align="center">T2-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B27">27.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">141.</T.d> <td align="center">T2-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B31">37.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">88.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B68">32.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">1500</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B5">5</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">245.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B23">23.</a>］</T.d> <td align="center">IHC.</T.d> <td align="center">89.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr> <td align="left"> [<a href="#B32">28.</a>］</T.d> <td align="center">RT-PCR.</T.d> <td align="center">88.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left"> [<a href="#B65">29.</a>］</T.d> <td align="center">RT-PCR.</T.d> <td align="center">73.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="left" colspan="5"> <hr></td> </tr> <tr> <td align="left">ErbB3或ErbB4</T.d> <td align="center"></td> <td align="center"></td> <td align="center"></td> <td align="center"></td> </tr> <tr> <td align="left" rowspan="2"> [<a href="#B18">16.</a>］<br></td> <td align="center">IHC.</T.d> <td align="center">128.</T.d> <td align="center">T0-4</T.d> <td align="center">NS</T.d> </tr> <tr> <td align="center">IHC.</T.d> <td align="center">124.</T.d> <td align="center">T0-4</T.d> <td align="center">是的</T.d> </tr> <tr class="table-tr"> <td colspan="5"> <hr class="tbody-hr"></td> </tr> </tbody> </table></td> </tr> </tbody> </table> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表3</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/tab3/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> ERBB受体家族作为膀胱癌死亡标志物的意义。</div> </div> </div> <div class="floats-partial-section partial-carousel-wrapper" data-section="fig2"> <div class="floats-partial-content fig-content-fig2"> <div class="partial-carousel--single-image"> <img alt="(a)膀胱癌死亡的EGFR＂name="181964.fig.002a" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.002a.jpg"> <br> <strong>(a)膀胱癌死亡的EGFR</strong> </div> <div class="partial-carousel--single-image"> <img alt="（b）中的ErbB2膀胱癌死亡＂name="181964.fig.002b" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.002b.jpg"> <br> <strong>（b）中的ErbB2膀胱癌死亡</strong> </div> </div> <div class="floats-partial-middle"> <div class="floats-partial-middle--thumbs fig-thumbs-fig2"> <button class="partial-carousel-dot" aria-label="(a) EGFR for bladder cancer death"><img alt="(a)膀胱癌死亡的EGFR＂name="181964.fig.002a" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.002a.jpg"><br><strong>(a)膀胱癌死亡的EGFR</strong></button> <button class="partial-carousel-dot" aria-label="(b) ErbB2 for bladder cancer death"><img alt="（b）中的ErbB2膀胱癌死亡＂name="181964.fig.002b" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.002b.jpg"><br><strong>（b）中的ErbB2膀胱癌死亡</strong></button> </div> <div class="partial-carousel-next-prev fig-nav-fig2"> <button class="carousel-prev" aria-label="Previous"></button> <button class="carousel-next" aria-label="Next"></button> </div> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">图2.</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/fig2/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> <table> 对膀胱癌死亡EGFR和ErbB2过度表达的预后意义的森林图。（a）中EGFR。（b）中的ErbB2。风险比和95％（置信区间）顺式对患者要么EGFR-或ErbB2阳性肿瘤。</T.able> </div> </div> </div> <h5 id="sec3.2">3.2。ErbB受体的共表达模式的意义</h5> <p>三项研究[<a href="#B5">5</a>，<a href="#B18">16.</a>，<a href="#B32">28.</a>]研究了ERBB受体家族成员与肿瘤复发和患者存活相关联的erbB受体家族的共表达模式的重要性。在预测肿瘤复发方面没有共表达模式均显着。相比之下，几种共表达模式是膀胱癌死亡的独立预后指标，即EGFR-ERBB2，ERBB2-ERBB3 [<a href="#B5">5</a>]，高EGFR或ERBB2加低ERBB3或ERBB4 [<a href="#B18">16.</a>，<a href="#B32">28.</a>] （桌子<a href="//www.newsama.com/journals/au/2012/181964/tab4/" target="_blank">4</a>）。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab4"> <div class="floats-partial-content fig-content-tab4"> <table class="table-group" id="tab4"> <tbody> <tr> <td> <table class="table"> <tbody> <tr> <td class="thead-hr" colspan="6"> <hr></td> </tr> <tr class="thead"> <td align="left" rowspan="2">研究名称</T.d> <td align="center" rowspan="2">方法</T.d> <td align="center" rowspan="2">积分没有。</T.d> <td align="center" rowspan="2">研究主题</T.d> <td align="left" colspan="2">为显著共表达图案</T.d> </tr> <tr class="thead"> <td align="left">循环</T.d> <td align="left">生存</T.d> </tr> <tr> <td class="thead-hr" colspan="6"> <hr></td> </tr> <tr> <td align="left" rowspan="2">［<a href="#B5">5</a>］<br></td> <td align="center" rowspan="2">IHC.</T.d> <td align="center" rowspan="2">245.</T.d> <td align="center" rowspan="2">T0-4</T.d> <td align="left" rowspan="2">EGFR-ERBB2-ERBB3<svg height="11.525" id="M10" style="vertical-align:-0.0pt" version="1.1" viewbox="0 0 6.4749999 11.525" width="6.4749999" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.525)"> <g transform="translate(72,-62.78)"> <text transform="matrix(1,0,0,-1,-71.95,67.83)"> <tspan style="font-size: 8.75px; " x="0" y="0"> *</T.span> </text> </g> </g> </svg></td> <td align="left">EGFR-ErbB2的</T.d> </tr> <tr> <td align="left">ErbB2的ErbB3的</T.d> </tr> <tr> <td align="left">［<a href="#B18">16.</a>］<br></td> <td align="center">IHC.</T.d> <td align="center">184.</T.d> <td align="center">T0-4</T.d> <td align="left">不重要</T.d> <td align="left">高EGFR +低erbb4</T.d> </tr> <tr> <td align="left" rowspan="2">［<a href="#B32">28.</a>］<br></td> <td align="center" rowspan="2">RT-PCR.</T.d> <td align="center" rowspan="2">88.</T.d> <td align="center" rowspan="2">T0-4</T.d> <td align="left" rowspan="2">尚未完成</T.d> <td align="left">EGFR高+低的ErbB3或ErbB4</T.d> </tr> <tr> <td align="left">高的ErbB2 +低的ErbB3或ErbB4</T.d> </tr> <tr class="table-tr"> <td colspan="6"> <hr class="tbody-hr"></td> </tr> </tbody> </table></td> </tr> <tr class="table-fn"> <td> <svg height="11.75" id="M11" style="vertical-align:-0.17555pt" version="1.1" viewbox="0 0 70.300003 11.75" width="70.300003" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.75)"> <g transform="translate(72,-62.6)"> <text transform="matrix(1,0,0,-1,-71.95,67.83)"> <tspan style="font-size: 8.75px; " x="0" y="0"> *</T.span> </text> <text transform="matrix(1,0,0,-1,-66.87,62.83)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 7</T.span> <tspan style="font-size: 12.50px; " x="44.810753" y="0"> 5</T.span> </text> </g> </g> </svg>．<br></td> </tr> </tbody> </table> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表4.</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/tab4/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> ErbB受体家族共表达可作为膀胱癌预后的标志物。</div> </div> </div> <h5 id="sec3.3">3.3。评估和出版物偏见</h5> <p>发表偏倚的一个显着的不对称漏斗图提示终被外界关注的ErbB2（图<a href="//www.newsama.com/journals/au/2012/181964/fig3/" target="_blank">3（b）</a>）。然而，没有发现EGFR的明显漏斗曲线，可能是因为仅分析了4项研究（图<a href="//www.newsama.com/journals/au/2012/181964/fig3/" target="_blank">3（a）</a>）。</p> <div class="floats-partial-section partial-carousel-wrapper" data-section="fig3"> <div class="floats-partial-content fig-content-fig3"> <div class="partial-carousel--single-image"> <img alt="(a)膀胱癌进展的EGFR＂name="181964.fig.003a" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.003a.jpg"> <br> <strong>(a)膀胱癌进展的EGFR</strong> </div> <div class="partial-carousel--single-image"> <img alt="（b）中的ErbB2膀胱癌死亡＂name="181964.fig.003b" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.003b.jpg"> <br> <strong>（b）中的ErbB2膀胱癌死亡</strong> </div> </div> <div class="floats-partial-middle"> <div class="floats-partial-middle--thumbs fig-thumbs-fig3"> <button class="partial-carousel-dot" aria-label="(a) EGFR for bladder cancer progression"><img alt="(a)膀胱癌进展的EGFR＂name="181964.fig.003a" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.003a.jpg"><br><strong>(a)膀胱癌进展的EGFR</strong></button> <button class="partial-carousel-dot" aria-label="(b) ErbB2 for bladder cancer death"><img alt="（b）中的ErbB2膀胱癌死亡＂name="181964.fig.003b" src="https://static-01.hindawi.com/articles/au/volume-2012/181964/figures/181964.fig.003b.jpg"><br><strong>（b）中的ErbB2膀胱癌死亡</strong></button> </div> <div class="partial-carousel-next-prev fig-nav-fig3"> <button class="carousel-prev" aria-label="Previous"></button> <button class="carousel-next" aria-label="Next"></button> </div> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">图3.</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/fig3/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> <table> EGFR和ErbB2发表偏倚漏斗图。(a) EGFR漏斗图未见明显不对称，因为只分析了四项研究。(b)发现ErbB2漏斗图存在大量不对称，表明存在发表偏倚。</T.able> </div> </div> </div> <h5 id="sec3.4">3．4．靶向ErbB信号在人膀胱癌中的临床研究</h5> <p>直到2012年2月，有6个成品临床试验靶向人膀胱癌ErbB信号（表<a href="//www.newsama.com/journals/au/2012/181964/tab5/" target="_blank">5</a>）。西妥昔单抗是用于阻断EGFR信号传导的嵌合（小鼠/人）单克隆抗体。II期临床试验[<a href="#B62">38.</a>39名预处理的患有转移性泌尿道上皮癌表明，西妥昔单抗组合的和紫杉醇化学疗法产生了更好的响应率（28.5％）比没有西妥昔单抗单一疗法，其中11 9的患者疾病进展在8周。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab5"> <div class="floats-partial-content fig-content-tab5"> <table class="table-group" id="tab5"> <tbody> <tr> <td> <table class="table"> <tbody> <tr> <td class="thead-hr" colspan="4"> <hr></td> </tr> <tr class="thead"> <td align="left">研究药物</T.d> <td align="center">积分没有。</T.d> <td align="left">ORR（％）</T.d> <td align="left">推荐</T.d> </tr> <tr> <td class="thead-hr" colspan="4"> <hr></td> </tr> <tr> <td align="left">EGFR信号</T.d> <td align="center"></td> <td align="left"></td> <td align="left"></td> </tr> <tr> <td align="left"> Cetuximab + paclitaxel versus cetuximab</T.d> <td align="center">39.</T.d> <td align="left">28.5与18</T.d> <td align="left">组合值得进一步评价[<a href="#B62">38.</a>］</T.d> </tr> <tr> <td align="left">吉替尼+吉西他滨，顺铂</T.d> <td align="center">58.</T.d> <td align="left">42.6％</T.d> <td align="left">顺铂、吉西他滨和吉非替尼的联合耐受性良好，吉非替尼的加入似乎没有改善缓解率或生存率[<a href="#B33">39.</a>，<a href="#B34">40</a>］</T.d> </tr> <tr> <td align="left">Geftinib</T.d> <td align="center">31.</T.d> <td align="left">6.5</T.d> <td align="left">吉替尼(ZD1839)作为二线药物治疗尿路上皮癌无效[<a href="#B35">41.</a>］</T.d> </tr> <tr> <td align="left" colspan="4"> <hr></td> </tr> <tr> <td align="left">EGFR和ERBB2信令</T.d> <td align="center"></td> <td align="left"></td> <td align="left"></td> </tr> <tr> <td align="left">拉帕替尼</T.d> <td align="center">59.</T.d> <td align="left">ORR（1.7％）和<br>SD（31％）</T.d> <td align="left">否定的结果，但临床益处（ORR和SD）与EGFR过度表达相关（<svg height="11.0375" id="M12" style="vertical-align:-0.27588pt" version="1.1" viewbox="0 0 63.962502 11.0375" width="63.962502" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.0375)"> <g transform="translate(72,-63.17)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 2</T.span> <tspan style="font-size: 12.50px; " x="44.810753" y="0"> 9</T.span> </text> </g> </g> </svg>），并且在某种程度上，她的2次过度表达[<a href="#B36">42.</a>］</T.d> </tr> <tr> <td align="left" colspan="4"> <hr></td> </tr> <tr> <td align="left">EGFR, VEGFR和RET信号通路</T.d> <td align="center"></td> <td align="left"></td> <td align="left"></td> </tr> <tr> <td align="left">凡德他尼加上多西他赛与安慰剂加上多西他赛</T.d> <td align="center">142.</T.d> <td align="left">ORR, 7对11 (<svg height="11.1" id="M13" style="vertical-align:-0.17555pt" version="1.1" viewbox="0 0 56.150002 11.1" width="56.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.1)"> <g transform="translate(72,-63.12)"> <text transform="matrix(1,0,0,-1,-71.95,63.35)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 5</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 6</T.span> </text> </g> </g> </svg>）;PFS，<br>2．6 m versus 1.6 m (<svg height="11.0375" id="M14" style="vertical-align:-0.27588pt" version="1.1" viewbox="0 0 63.962502 11.0375" width="63.962502" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.0375)"> <g transform="translate(72,-63.17)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 9</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 3.</T.span> <tspan style="font-size: 12.50px; " x="44.810753" y="0"> 9</T.span> </text> </g> </g> </svg>）;OS, 5.9 m vs 7.0 m (<svg height="10.9125" id="M15" style="vertical-align:-0.17555pt" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.9125)"> <g transform="translate(72,-63.27)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 3.</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 4</T.span> <tspan style="font-size: 12.50px; " x="44.810753" y="0"> 7</T.span> </text> </g> </g> </svg>）</T.d> <td align="left">加入凡德他尼多烯紫杉醇并没有导致PFS，ORR，或OS [一个显著改善<a href="#B37">43.</a>］</T.d> </tr> <tr class="table-tr"> <td colspan="4"> <hr class="tbody-hr"></td> </tr> </tbody> </table></td> </tr> <tr class="table-fn"> <td>ORR：客观反应率;SD：病情稳定，PFS：无进展生存期;OS：整体生存;VEGFR：血管内皮生长因子受体;RET：转染期间重排。<br></td> </tr> </tbody> </table> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表5.</span> <a aria-label="full view" class="caption-partial-url" href="//www.newsama.com/journals/au/2012/181964/tab5/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> 发表的临床试验在尿路上皮癌患者的靶向EGFR信号的更新结果。</div> </div> </div> <p>Gefitinib是EGFR酪氨酸激酶结构域的第一选择性抑制剂。在用吉西他滨和顺铂化疗加上吉替尼治疗的58例患有58例转移性尿路上皮癌患者的II期试验中，还证明了42.6％（95％CI：29.2-56.8％）的整体反应率。<a href="#B33">39.</a>，<a href="#B34">40</a>[中位生存时间为15.1个月（95％CI：11.1-21.7 mo），进展时间为7.4个月（95％CI：5.6-9.2 MO）。二十五名患者完成了审判而不减少或停止吉非替尼。作者得出结论，这种联合治疗在转移性疾病中具有良好耐受性和有效。然而，添加Gefitinib并未提高响应率或患者存活率。相比之下，31例预处理尿路上皮癌的第二期试验[<a href="#B35">41.</a>报告的回复率为6.5％，而作者得出结论，吉替尼作为转移性尿路上皮癌的第二型药剂无效。</p> <p>拉帕替尼是EGFR和ErbB2双酪氨酸激酶抑制剂。客观响应率（ORR）大于10％，用拉帕替尼作为二线剂治疗转移性泌尿道上皮癌的II期试验只有59的1例（1.7％）中发现的[<a href="#B36">42.</a>]，和疾病是在这些患者（31％）的18稳定化。结果基本上是否定的。有趣的是，临床优点（ORR和病情稳定）与EGFR过度表达相关（<svg height="11.0375" id="M16" style="vertical-align:-0.27588pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.0375" width="63.962502" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.0375)"> <g transform="translate(72,-63.17)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 2</T.span> <tspan style="font-size: 12.50px; " x="44.810753" y="0"> 9</T.span> </text> </g> </g> </svg>)，在某种程度上，HER-2过度表达。</p> <p>凡德他尼是EGFR的酪氨酸激酶抑制剂，血管内皮生长因子受体（VEGFR）和RET（转染期间重排）。Choueiri等。报道称，联合凡德他尼和多西紫杉醇没有为ORR或大于142例转移性尿路上皮癌双盲试验做多西他赛加安慰剂患者的生存提供了更多的好处。毒性是在组合组中也越大[<a href="#B37">43.</a>］．综合来看，目前临床试验的结果表明，更多的调查是必须的，以确定合适的战略或治疗的设计，病人尿路上皮癌靶向ErbB信号更有效的药物。</p> <h4 id="discussion">4.讨论</h4> <p>该meta分析显示，不同研究对ErbB受体家族成员表达的估计差异很大。然而，EGFR过表达是膀胱癌患者进展和死亡率的中度预测。ErbB2过表达对癌症死亡率的预测能力较弱。由于对ErbB3和ErbB4意义的研究相对较少，现阶段还不能得出结论。然而，这些发现应该仔细解释，因为相对较少的研究有资格进行分析。</p> <p>EGF和EGFR发现至今已有30多年[<a href="#B38">44.</a>，<a href="#B39">45.</a>］．许多膀胱癌研究检查了该受体家族的信号事件[<a href="#B18">16.</a>，<a href="#B40">46.</a>，<a href="#B41">47.</a>］．鉴于人尿液含有高浓度的EGF（20ng / mg肌酐）[<a href="#B42">48.</a>]和转化生长因子（TGF） -<svg height="7.1750002" id="M17" style="vertical-align:-0.1254pt;width:8.9375px;" version="1.1" viewbox="0 0 8.9375 7.1750002" width="8.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,7.175)"> <g transform="translate(72,-66.26)"> <text transform="matrix(1,0,0,-1,-71.95,66.44)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> </g> </g> </svg>(0.6 ng/mg creatinine) [<a href="#B43">49.</a>]，配体与其认知受体的相互作用已经认为在膀胱粘膜的稳态中至关重要。该假设是通过临床观察来支持的，所述临床观察结果与原发性肿瘤中的EGFR表达的强度与原发性肿瘤中的EGFR表达相反相关（<svg height="10.9125" id="M18" style="vertical-align:-0.17555pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 10.9125" width="56.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.9125)"> <g transform="translate(72,-63.27)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ＝</T.span> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> ．</T.span> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</T.span> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 4</T.span> </text> </g> </g> </svg>）[<a href="#B41">47.</a>］．这一发现支持了尿EGF和尿路上皮EGFR相互作用在人类膀胱癌发病机制中的重要性。</p> <p>当配体与特定RTK的细胞外结构域结合时，其细胞内结构域的酪氨酸激酶活性被激活[<a href="#B44">50.</a>］．ErbB受体家族的几个调节信号通路在人类癌症的增殖、血管生成、迁移和转移中是重要的[<a href="#B45">51.</a>］．传统的范例是ErbB受体的异常活化由过表达或该受体的突变产生，并且由自分泌产生的配体[<a href="#B44">50.</a>］．目前已知，EGFR的信号输出相当复杂。不仅酪氨酸磷酸化的EGFR参与至少6个生化下游途径，而且EGFR家族RTKs还包括其他3个受体，其中只有ErbB4是自主的[<a href="#B46">52.</a>］．可以在同一细胞中共混合并激活其他ERBB蛋白质，导致它们与EGFR的二聚。EGFR与ERBB2的关联防止其下调，增强了EGFR的生物学效应[<a href="#B47">53.</a>］．</p> <p>ErbB信号可以终止或通过其它机制，例如配体的解离，这导致受体的去磷酸化或降解[钝<a href="#B48">54.</a>，<a href="#B49">55.</a>］．alwan等人。假设，在蛋白酶体配体诱导的内吞作用的ErbB蛋白或溶酶体降解的靶向参与EGFR下调[<a href="#B50">56.</a>］．因为ErbB受体家族有许多负反馈机制（例如，胞吞受体，磷酸化，泛素化和/去泛素化）和串扰与其他途径（如NOTCH途径，VEGF，TGF-β和<svg height="13.425" id="M19" style="vertical-align:-2.29482pt;width:8.8500004px;" version="1.1" viewbox="0 0 8.8500004 13.425" width="8.8500004" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,13.425)"> <g transform="translate(72,-61.26)"> <text transform="matrix(1,0,0,-1,-71.95,63.6)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </T.span> </text> </g> </g> </svg>），EGFR / ERBB网络的组成部分是癌症治疗的优异目标[<a href="#B51">57.</a>］．</p> <p>若干研究报告说，过表达或突变的EGFR家族成员推动人类癌症的发展，包括肺部[<a href="#B52">58.</a>]，胸部 [<a href="#B53">59.</a>],黑色素瘤[<a href="#B54">60.</a>]，前列腺[<a href="#B55">61.</a>]和膀胱癌[<a href="#B56">62.</a>］．另外，其他畸变，如RAF或PI3K的突变形式，通过负反馈循环操纵癌症下游信号[<a href="#B57">63.</a>］．因此，EGFR / ERBB信令的计算图表可以引导小区命运决定。总共，可以想到推测评估个体ERBB家族受体表达不足以估算癌症患者的生物潜力。</p> <p>许多研究报道了EGFR和ErbB2过表达与膀胱癌晚期的相关性。这些表型被认为可以预测患者的生存，以及对化疗的反应[<a href="#B58">64.</a>，<a href="#B59">65.</a>］．然而，这些生物标志物未被纳入膀胱癌患者的分子指标[<a href="#B60">66.</a>，<a href="#B61">67.</a>］．这篇综述描述了ErbB受体表达在预测膀胱癌患者复发、进展和死亡风险方面的有效性的真实不一致。在某种程度上，这种不一致性与专注于阻断ErbB受体信号传导的临床试验令人沮丧的结果是一致的[<a href="#B62">38.</a>，<a href="#B34">40</a>- - - - - -<a href="#B37">43.</a>］．</p> <p>负责在这个荟萃分析的差异的因素包括从染色得分患者招募的长时间，广泛的疾病状态（T0-1，T0-4，T2-4）的，可变性在免疫组织化学测定法中使用，偏置，截止点，主观性和解释结果。有附加贡献因素，即，后续的长度，用于检测感兴趣的事件策略，并在不一致的夹杂物的临床和病理因素的多变量分析[<a href="#B63">68.</a>］．毫不奇怪，不同的治疗计划可能对临床结果产生不同的影响，这可能不被视为一个混杂因素[<a href="#B64">69.</a>］．在我们的荟萃分析计算出的风险可以通过，因为风险比和95个％CI时，协会并没有显著未说明报告偏倚被高估。</p> <h4 id="conclusions">5。结论</h4> <p>总之，该荟萃分析揭示了膀胱癌患者伯伯家族受体表达和进展和死亡率之间的重大关联，即使这些发现需要仔细解释这些结果。考虑到当前的分子信息，评估ERBB家族共表达模式可以为膀胱癌患者提供更好的预后信息。更新的临床试验表明，需要更多的调查来识别尿液癌ERBB信号的有效药剂。在接受ERBB受体表达模式之前强制进行系统的评价和荟萃分析作为临床应用的预测标志物。</p> <h4 id="conflict-of-interests">利益冲突</h4> <p>作者宣称没有利益冲突。</p> <h4 id="acknowledgments">致谢</h4> <p>本项目由美国国立卫生研究院nri - ex99 - 9930bi基金和台湾国家科学委员会NSC 98-2314-B-006-033-MY2基金资助。</p> </div> <div class="xml-content"> <h4 class="references" id="references">参考文献</h4> <ol> <li id="B1">A. 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Nascimento et al.&publication_year=2005" target="_blank">谷歌学术</a></span></li> </ol> </div> <div class="xml-content"> <h4 class="copyright" id="copyright">版权</h4> <p>版权所有©2012煜娴蔡等人。这是分布下的开放式访问文章<a rel="license" href="http://creativecommons.org/licenses/by/3.0/">知识共享署名许可协议</a>，允许在任何媒介上不受限制地使用、传播和复制，但必须正确引用原作。</p> </div> </div> </article> </div> </div> </div> <div class="biblio__Wrapper-sc-1nou1lz-0 eyHfWh journal_article__BiblioIntegratorWidget-sc-12fk6zy-5 dbAANp article_widget biblioWrapper hide"> <hr> <h4 class="biblio__H4-sc-1nou1lz-2 kgAKHb hrTitleRef">更多相关文章</h4> <div id="biblio_widget" class="biblio__BiblioWrapper-sc-1nou1lz-1 fOXysy"></div> </div> </div> </div> <div class="threeColumn__RightWrapper-sc-1bf4078-2 jzTMLK rightWrapper" id="rightSectionMenu"> <div> <div class="journal_article__ArticleStickyTopToolbar-sc-12fk6zy-0 gbrQxi article_sticky_top_toolbar"> <div class="sc-cBdUnI hRnXob article_top_toolbar"> <a class="sc-htpNat bUhGXt link sc-jtRfpW dIjoCg sc-exkUMo hymroZ 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height="24"></a> <a class="sc-htpNat bUhGXt link sc-iNhVCk gWgCNb open_panel" href="//www.newsama.com/downloads/journals/au/2012/181964.xml" aria-label="XML" property="background-color" color="#D8D8D8"> <div class="sc-eAKXzc WHkfb"> XML</div><img alt="" class="sc-EHOje jOLhQl sc-bfYoXt cGuwDn" title="" role="presentation" 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height="24"><span class="sc-dRFtgE jrsDZP">订单打印副本</span><span class="sc-gkFcWv gWTCXQ">命令</span></span><span class="sc-htoDjs kNoiZu sc-gbOuXE jGPvPL right__icon icon-colored _32KP5uexH-Bgs7Kj8Gk1Tz icon-themeable" title="" font-size="16"></span></a> <div class="sc-hBbWxd kdRRST"> <div class="sc-dyGzUR cHatnS"> <div> 意见<span>1653.</span> </div> <div> 下载<span>869.</span> </div> </div> <div> <div class="sc-drKuOJ kxdGAZ"> <span class="__dimensions_badge_embed__" data-doi="10.1155/2012/181964" data-style="small_circle"></span>引用</div> </div> </div> <nav class="sc-bRBYWo fXBKFa sc-hUfwpO jHPgUP" id="toolbar__iconNav"> <h3 class="sc-Rmtcm hNPrIr">分享文章</h3> <ul class="sc-hzDkRC bnbfTS"> <li class="iconBorder"><a class="sc-htpNat bUhGXt link" href="https://twitter.com/share?url=https://doi.org/10.1155/2012/181964&via=Hindawi" aria-label="Sharing on Twitter" rel="noopener noreferrer" target="_blank"><img alt="" class="sc-EHOje jOLhQl socialTwitter" title="" role="presentation" 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