Stuart-Harris R, Caldas C, Pinder S E, Pharoah P
Cancer Research UK Cambridge Research Institute, Department of Oncology, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK.
Breast. 2008 Aug;17(4):323-34. doi: 10.1016/j.breast.2008.02.002. Epub 2008 May 2.
We have performed a systematic review and meta-analysis of proliferation markers (Ki-67, mitotic index (MI), proliferating cell nuclear antigen (PCNA) and thymidine or bromodeoxyuridine labelling index (LI)) with respect to survival in early breast cancer. Eighty-five studies involving 32,825 patients were analysed. Ki-67 (43 studies, 15,790 patients), MI (20 studies, 7021 patients), and LI (11 studies, 7337 patients) were associated with significantly shorter overall and disease free survival, using results from univariate and multivariate analyses from the individual studies. PCNA (11 studies, 2677 patients) was associated with shorter overall survival by multivariate analysis only, because of lack of data. There was some evidence for publication bias, but all markers remained significant after allowing for this. Ki-67, MI, PCNA and LI are associated with worse survival outcomes in early breast cancer. However, whether these proliferation markers provide additional prognostic information to commonly used prognostic indices remains unclear.
我们针对早期乳腺癌患者的生存情况，对增殖标志物（Ki-67、有丝分裂指数（MI）、增殖细胞核抗原（PCNA）以及胸腺嘧啶或溴脱氧尿苷标记指数（LI））进行了一项系统综述和荟萃分析。分析了涉及32,825例患者的85项研究。根据各项研究的单变量和多变量分析结果，Ki-67（43项研究，15,790例患者）、MI（20项研究，7021例患者）以及LI（11项研究，7337例患者）与总体生存期和无病生存期显著缩短相关。PCNA（11项研究，2677例患者）仅在多变量分析中与总体生存期缩短相关，原因是数据不足。有证据表明存在发表偏倚，但考虑到这一点后，所有标志物仍具有显著性。Ki-67、MI、PCNA和LI与早期乳腺癌较差的生存结果相关。然而，这些增殖标志物是否能为常用的预后指标提供额外的预后信息仍不清楚。
