Department of Breast Surgery, Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Onco Targets Ther. 2014 Apr 10;7:543-52. doi: 10.2147/OTT.S60115. eCollection 2014.
Mutations of the p110α catalytic subunit of phosphatidylinositol 3-kinase (PIK3CA) are among the most common genetic aberrations in human breast cancer. At present, controversy exists concerning the prognostic value of the mutations.
We performed a systematic review and meta-analysis to clarify the association between PIK3CA mutations and survival outcomes. A comprehensive, computerized literature search of PubMed, Web of Science databases, the Chinese Biomedical Literature Database, and Wangfang Data until August 27, 2013 was carried out. Eligible studies were included according to specific inclusion criteria. Pooled hazard ratio was estimated by using the fixed effects model or random effects model according to heterogeneity between studies.
Eight eligible studies were included in the analysis, all of which were retrospective cohort studies. The overall meta-analysis demonstrated that the PIK3CA mutations were associated with better clinical outcomes (hazard ratio 0.72; 95% confidence interval: 0.57-0.91; P=0.006). None of the single studies materially altered the original results and no evidence of publication bias was found. Further subgroup analysis of mutations in exons 9 and 20 did not show statistical significance.
PIK3CA mutations in operable primary breast cancer indicate a good prognosis. Further studies should be conducted to investigate the effect of PIK3CA mutations on clinical outcomes in different histologic types, different molecular subtypes of breast cancer, and different exons of PIK3CA.
磷脂酰肌醇 3-激酶（PI3K）的 p110α 催化亚基的突变是人类乳腺癌中最常见的遗传异常之一。目前，关于突变的预后价值存在争议。
我们进行了系统评价和荟萃分析，以阐明 PIK3CA 突变与生存结果之间的关联。对 PubMed、Web of Science 数据库、中国生物医学文献数据库和万方数据进行了全面的计算机文献检索，检索时间截至 2013 年 8 月 27 日。根据具体纳入标准纳入合格研究。根据研究之间的异质性，使用固定效应模型或随机效应模型估计合并风险比。
共有 8 项合格研究纳入分析，均为回顾性队列研究。总体荟萃分析表明，PIK3CA 突变与较好的临床结局相关（风险比 0.72；95%置信区间：0.57-0.91；P=0.006）。没有任何一项单独的研究实质性地改变了原始结果，也没有发现发表偏倚的证据。对 9 号和 20 号外显子突变的亚组分析也没有显示出统计学意义。
可手术原发性乳腺癌中的 PIK3CA 突变预示着较好的预后。应进一步研究 PIK3CA 突变对不同组织学类型、不同分子亚型乳腺癌以及 PIK3CA 不同外显子的临床结局的影响。
