RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Effects of Kang'ai injection combined with chemotherapy on immune function in advanced non-small cell lung cancer: a meta-analysis.
Effects of Kang'ai injection combined with chemotherapy on immune function in advanced non-small cell lung cancer: a meta-analysis.
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系统评价康艾注射液(KAI)联合铂类化疗对晚期非小细胞肺癌患者免疫功能、临床疗效和安全性的影响。
将通过系统检索中英文电子数据库,识别各数据库建库至2025年9月期间发表的相关文献。根据预先制定的纳入和排除标准,筛选评估康艾注射液联合化疗治疗晚期非小细胞肺癌的随机对照试验(RCT)。两名研究者将独立进行数据提取和质量评价。使用RevMan 5.3和Stata 18.0软件进行Meta分析。采用漏斗图和Egger's检验评估发表偏倚,并通过试验序贯分析(TSA)检验结果的稳健性。采用GRADE方法评价关键结局的证据质量。
共纳入14项随机对照试验,涉及1,214例患者。Meta分析显示,与单纯化疗相比,KAI联合化疗显著提高了客观缓解率并增强了免疫功能指标,包括CD3+和CD4+T细胞计数增加、CD4+/CD8+比值升高、NK 细胞百分比升高,同时降低了CD8+T细胞百分比。与单纯化疗组相比,联合治疗组在降低肿瘤标志物和血管内皮生长因子水平方面也显示出更优的结果。此外,联合治疗显著降低了化疗相关不良反应的发生率,包括白细胞减少、骨髓抑制、恶心呕吐和胃肠道反应。
作为辅助治疗,KAI可增强晚期NSCLC患者的免疫功能(低质量证据),提高化疗的客观缓解率(中等质量证据),并减轻化疗相关毒性(主要为中等质量证据),为临床综合管理提供了循证参考。
Systematically evaluate the effects of Kang'ai Injection (KAI) combined with platinum-based chemotherapy on immune function, clinical efficacy, and safety in patients with advanced non-small cell lung cancer.
Relevant literature published from the inception of each database through September 2025 will be identified through systematic searches of Chinese and English electronic databases. Randomized controlled trials (RCTs) evaluating Kang'ai injection combined with chemotherapy for advanced non-small cell lung cancer will be screened against predefined inclusion and exclusion criteria. Two investigators will independently perform data extraction and quality assessment. Meta-analyses will be conducted using RevMan 5.3 and Stata 18.0 software. Publication bias will be assessed using funnel plots and Egger's test, while the robustness of findings will be examined through trial sequential analysis (TSA). The quality of evidence for critical outcomes will be evaluated using the GRADE approach.
A total of 14 randomized controlled trials involving 1,214 patients were included. The meta-analysis demonstrated that compared with chemotherapy alone, KAI combined with chemotherapy significantly improved the objective response rate and enhanced immune function parameters, including increased CD3 + and CD4 + T-cell counts, elevated CD4 + /CD8 + ratio, and higher natural killer cell percentage, while reducing CD8 + T-cell percentage. The combination therapy group also showed superior outcomes in reducing tumor marker and vascular endothelial growth factor levels compared to the chemotherapy-alone group. Furthermore, combination treatment significantly reduced the incidence of chemotherapy-related adverse reactions including leukopenia, myelosuppression, nausea and vomiting, and gastrointestinal reactions.
As an adjunctive therapy, KAI can enhance immune function (low-quality evidence), improve the objective response rate to chemotherapy (moderate-quality evidence), and alleviate chemotherapy-related toxicities (predominantly moderate-quality evidence) in patients with advanced NSCLC, providing an evidence-based reference for comprehensive clinical management. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251168090.
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