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| 系統識別號 |
U0026-2410201810301200 |
| 論文名稱(中文) |
探討microRNA-29a於人體肝癌中所扮演的角色:統合分析研究 |
| 論文名稱(英文) |
Role of microRNA-29a in human hepatocellular carcinoma: a meta-analysis |
| 校院名稱 |
成功大學 |
| 系所名稱(中) |
分子醫學研究所 |
| 系所名稱(英) |
Institute of Molecular Medicine |
| 學年度 |
107 |
| 學期 |
1 |
| 出版年 |
107 |
| 研究生(中文) |
吳姿璿 |
| 研究生(英文) |
Tz-Shiuan Wu |
| 學號 |
T16051016 |
| 學位類別 |
碩士 |
| 語文別 |
中文 |
| 論文頁數 |
48頁 |
| 口試委員 |
指導教授-張定宗
召集委員-楊孔嘉
口試委員-吳毅晉
|
| 中文關鍵字 |
hepatocellular carcinoma
miR-29a
統計整合分析
生物標記
腫瘤抑制
|
| 英文關鍵字 |
hepatocellular carcinoma
miR-29a
meta-analysis
tumor suppressor
biomarker
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| 學科別分類 |
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| 中文摘要 |
肝癌(hepatocellular carcinoma, HCC)為目前世界最常見的癌症之一，也是癌症致死率排名第三名的癌症。通常大多數的肝癌病患都在末期時才被確診，因而容易錯過了治療的黃金時期，且肝癌的癌化與轉移速度很快，故若能找到一個早期的、非侵入性的臨床標記物(biomarker)也變得更加重要。
小分子核糖核酸-29a (microRNA-29a；miR-29a)為第一個被發現與癌症有關的小分子核糖核酸。近幾年很多文獻都曾報導過miR-29a與很多實質固態瘤(solid cancer)是有相關性的。然而肝癌與miR-29a之間的相關性卻鮮少被提及，故在本篇研究，我們會以統合分析研究(meta-analysis)去針對HCC與miR-29a之間的相關性進行統計分析，探討miR-29a於肝癌中所扮演的角色。
我們從文獻搜尋的瀏覽器找出的7,464篇研究中，最終再根據我們所設定的標準去篩選出9篇研究來進行統計分析。從文獻中取得相關資訊進行統計，其中高度表現miR-29a的病患中，共有282個人存活、295個人死亡，而低度表現miR-29a的患者中，共有215個人存活、383個人死亡。其餘沒有顯示人數之文獻，我們會直接以作者所提供的勝算比(odds ratio)進行分析。
根據統合分析結果指出，肝臟組織中表現低量miR-29a之患者，具有較高的風險發生肝癌，其勝算比為3.375，95%信賴區間為1.884-6.046，P值小於0.0001。而在死亡率與miR-29a表現量的分析當中，肝臟組織中表現低量miR-29a之患者，有較高的風險發生死亡，其勝算比為1.981，95%信賴區間為1.513-2.594，P值小於0.0001。
然而在我們出版誤差(publication bias)的分析當中，HCC與死亡率的分析皆各有三篇文獻沒有落在標準範圍中，故我們將其移除，移除後之勝算比為2.984，95%信賴區間為1.606-5.544，P值為0.001，仍顯示高度風險。而在死亡率與miR-29a的分析中也有三篇文獻之出版誤差不在扇形的範圍中，移除後之勝算比為1.733，95%信賴區間為1.236-2.431，P值為0.001，結果也與移除前相同。因此我們認為肝臟組織中表現低量miR-29a是可以做為一個HCC的發生以及預後較差的預測因子。
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| 英文摘要 |
Hepatocellular carcinoma (HCC) is one of the most common cancers in the world and the third leading cause of cancer-related death worldwide. However, most of HCC patients were diagnosed when enter the late stage and miss the chance of treatment. Therefore, to figure out a biomarker of HCC is important for therapy. MicroRNA-29a (miR-29a) is the first cancer-related miRNA which was found in 2001 in HeLa cell. In recent year, miR-29a have been reported that it is associated with many types of cancer. However, there are not many study mention the correlation between HCC and miR-29a. Therefore, in this study, we collect the study about HCC and miR-29a, and use statistical analysis software to observe the correlation between HCC/overall survival and miR-29a with large cohort. Nine of the 7,464 studies, which were searched from EMBASE, Google scholar, and PubMed, were selected for the meta-analysis.
After the systematic meta-analysis, low levels of miR-29a in tissues performed high risk in development of HCC and poor prognosis (HCC: OR=3.375, 95% Confidence interval (IC)=1.884-6.046, P<0.0001; prognosis: OR=1.981, 95% IC=1.513-2.594, P<0.0001). Three studies were excluded after the analysis of publication bias. There are no significant different exist (HCC: OR=2.984, 95% IC= 1.606-5.544, P=0.001; prognosis: OR=1.733, 95% IC=1.236-2.431, P=0.001) after correction of publication bias. In conclusion, we thought miR-29a might be a potential biomarker of HCC, which could predict poor prognosis and development of HCC.
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| 論文目次 |
中文摘要………………………………………………………I
英文延伸摘要 ………………………………………………III
致謝 ………………………………………………………XXI
壹、緒論 (Introduction) ……………………………………1
一、肝癌……………………………………………………1
1. 造成肝癌的原因………………………………………………1
2. 肝癌的偵測方法………………………………………………6
3. 肝癌的診斷……………………………………………………8
4. 肝癌的臨床分期………………………………………………8
5. 肝癌的治療……………………………………………………9
二、microRNA……………………………………………13
1. miRNA與其標的mRNA之間的相互作用…………………14
2. miRNA的調控 ………………………………………………15
3. miRNA於癌症中所扮演的角色 ……………………………17
三、 miR-29家族…………………………………………19
四、 miR-29a與肝癌目前之研究 ………………………21
貳、材料與方法(Material & Method) ……………………22
一、 文獻搜尋……………………………………………22
二、 納入分析之條件……………………………………22
三、 資料收集……………………………………………22
四、 統計分析……………………………………………23
參、結果(Result) …………………………………………24
一、文獻的選擇 …………………………………………24
二、文獻分類 ……………………………………………24
三、 miR-29a與HCC以及存活率之間的相關性………25
四、 miR-29a與HCC……………………………………25
肆、討論 (Discussion) ……………………………………28
伍、 參考文獻 (Reference) ………………………………29
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