Table 1_Cancer-associated fibroblasts and their prognostic role in colorectal cancer: review and meta-analysis.docx

BackgroundCancer-associated fibroblasts (CAFs) are a component of the tumor microenvironment, influencing tumor behavior and progression. This meta-analysis aims to describe the prognostic value of CAF biomarkers in colorectal cancer (CRC).
MethodsA systematic search of the existing literature was performed in Medline and Embase on CAF immunohistochemical (IHC) biomarkers and their association with disease-free survival (DFS) and overall survival (OS). The selection of studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Population, Intervention, Comparator, Outcome criteria. The quality of the included articles was assessed using the Newcastle–Ottawa Scale.
ResultsA total of 3,535 records were identified, of which 84 were selected for the qualitative review and 59 (N = 15,396 patients) were included in the final meta-analysis. In general, CAF biomarker expression was associated with poor prognosis, with high heterogeneity among studies. Significant results for DFS were found for cluster of differentiation (CD) 163, matrix metalloproteinase 9 (MMP-9), and tenascin C. The following markers were significantly associated with OS: CD163, MMP-9, periostin, and vimentin.
ConclusionSeveral CAF IHC biomarkers, particularly CD163, MMP-9, periostin, and vimentin, significantly associated with prognosis in CRC, could be proposed as surrogates for the phenotypical characterization of the tumor microenvironment.

背景 癌相关成纤维细胞（Cancer-associated fibroblasts, CAFs）是肿瘤微环境的组成成分，可调控肿瘤的生物学行为与进展。本项荟萃分析旨在探讨癌相关成纤维细胞生物标志物在结直肠癌（Colorectal cancer, CRC）中的预后价值。
方法 本研究在Medline与Embase数据库中开展系统性文献检索，检索主题为癌相关成纤维细胞免疫组织化学（Immunohistochemical, IHC）生物标志物及其与无病生存期（Disease-free survival, DFS）和总生存期（Overall survival, OS）的相关性。研究筛选严格遵循《系统评价与荟萃分析优先报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南以及人群、干预、对照、结局（Population, Intervention, Comparator, Outcome, PICO）标准。采用纽卡斯尔-渥太华量表（Newcastle–Ottawa Scale, NOS）对纳入文献的质量进行评估。
结果 本研究共检索到3535条文献记录，其中84篇纳入定性综述，最终59篇（共纳入15396例患者）纳入本次荟萃分析。整体而言，癌相关成纤维细胞生物标志物的高表达与不良预后相关，且各研究间存在较高异质性。针对无病生存期的分析显示，分化簇（Cluster of differentiation, CD）163、基质金属蛋白酶9（Matrix metalloproteinase 9, MMP-9）及腱糖蛋白C的表达与不良预后显著相关。与总生存期显著相关的标志物包括CD163、MMP-9、骨膜蛋白（periostin）及波形蛋白（vimentin）。
结论 多种癌相关成纤维细胞免疫组织化学生物标志物，尤其是CD163、MMP-9、骨膜蛋白及波形蛋白，与结直肠癌患者的预后显著相关，可作为肿瘤微环境表型特征分析的替代标志物。