Prognostic Value of SPARC in Patients with Pancreatic Cancer: A Systematic Review and Meta-Analysis

ObjectiveThere is a heated debate on whether the prognostic value of SPARC is favorable or unfavorable. Thus, we carried out a meta-analysis evaluating the relationship between SPARC expression and the prognosis of patients with pancreatic cancer.MethodsWe searched PubMed, EMBASE and Web of Science for relevant articles. The pooled hazard ratios (HRs) and corresponding 95%CI of overall survival (OS) were calculated to evaluate the prognostic value of SPARC expression in patients with pancreatic cancer. We also performed subgroup analyses.ResultsWith 1623 patients pooled from 10 available studies, the incorporative HR showed an unfavorable prognosis of patients with pancreatic cancer in the multivariate analysis (HR = 1.55, 95%CI: 1.11–2.17, P = 0.01), but not in univariate analysis (HR = 1.41, 95%CI: 0.47–4.21, P = 0.54) and estimate (HR = 1.24, 95%CI: 0.72–2.13, P = 0.44). And this adverse impact could also be found in the subgroup analyses in multivariate analysis, especially in the stroma (HR = 1.53, 95%CI: 1.05–2.24, P = 0.03). However, the combined HR had the highly significant heterogeneity. No obvious publication bias was found.ConclusionsSPARC might be an unfavorable indicator in patients with pancreatic cancer, especially in the stroma. More and further researches should be conducted to reveal the prognostic value of SPARC.

【研究目的】当前关于分泌型酸性富含半胱氨酸蛋白（SPARC）的预后价值究竟为正向还是负向尚存激烈争议。为此，本研究开展一项荟萃分析，旨在评估SPARC表达与胰腺癌患者预后之间的相关性。【研究方法】本研究检索了PubMed、EMBASE及Web of Science数据库中的相关文献。通过计算总生存期（OS）的合并风险比（HRs）及其对应的95%置信区间（95%CI），以评估SPARC表达对胰腺癌患者的预后价值。此外，本研究还进行了亚组分析。【研究结果】本研究共纳入10项符合条件的研究，涉及1623例患者。多因素分析结果显示，合并HR提示胰腺癌患者预后不良（HR=1.55，95%CI：1.11~2.17，P=0.01）；但单因素分析（HR=1.41，95%CI：0.47~4.21，P=0.54）及估算分析（HR=1.24，95%CI：0.72~2.13，P=0.44）中未观察到类似效应。亚组分析进一步证实，多因素分析下SPARC的不良预后作用同样存在，尤其在间质亚组中更为显著（HR=1.53，95%CI：1.05~2.24，P=0.03）。不过，合并HR存在高度显著的异质性，且未发现明显的发表偏倚。【研究结论】SPARC或可作为胰腺癌患者预后不良的预测指标，尤其在间质层面。未来仍需开展更多深入研究以明确SPARC的预后价值。