Li Shuting, Shen Yanwei, Wang Mengying, Yang Jiao, Lv Meng, Li Pan, Chen Zheling, Yang Jin
Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China.
Institute of Endemic Diseases, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, P.R. China.
Oncotarget. 2017 May 9;8(19):32043-32054. doi: 10.18632/oncotarget.16761.
Various studies have evaluated the significance of PTEN (phosphatase and tensin homolog deleted from chromosome 10) expression in breast cancer, but their results remain controversial. We conducted a meta-analysis to evaluate the associations of PTEN expression with clinicopathological characteristics and prognosis in breast cancer. PubMed, Embase, Web of Science, and China National Knowledge Infrastructure were searched to identify relevant publications. The associations between PTEN expression and clinicopathological parameters, disease-free survival (DFS), and overall survival (OS) were then assessed via meta-analyses of odds ratio (ORs) and hazard ratio (HRs) with 95% confidence intervals (CIs). Based on 27 studies involving 10,231 patients, the pooled results revealed that PTEN loss was significantly more common in breast cancer than in normal tissues (OR = 12.15, 95% CI = 6.48-22.79, P < 0.00001) and that PTEN loss had clear associations with larger tumor size (> 2 cm, OR = 0.62, 95% CI = 0.48-0.82, P = 0.0006), lymph node metastasis(OR = 0.61, 95% CI = 0.45-0.82, P = 0.0001), later TNM stage(stage III-IV, OR = 0.55, 95% CI = 0.35-0.86, P = 0.009), poor differentiation(OR = 0.37, 95% CI = 0.24-0.59, P < 0.0001), and the highly aggressive triple-negative phenotype (OR = 1.62, 95% CI = 1.23-2.12, P = 0.0005). Moreover, patients with PTEN loss exhibited significantly worse DFS and OS(HR = 1.63, 95% CI = 1.04-2.22, P < 0.00001; HR = 1.41, 95% CI = 1.08-1.73, P < 0.0001; respectively). In conclusion, PTEN loss might predict more aggressive behavior and worse outcomes in patients with breast cancer.
多项研究评估了10号染色体缺失的磷酸酶和张力蛋白同源物（PTEN）在乳腺癌中的表达意义，但其结果仍存在争议。我们进行了一项荟萃分析，以评估PTEN表达与乳腺癌临床病理特征及预后的相关性。通过检索PubMed、Embase、Web of Science和中国知网来识别相关出版物。然后通过对比值比（OR）和风险比（HR）进行荟萃分析，并计算95%置信区间（CI），来评估PTEN表达与临床病理参数、无病生存期（DFS）和总生存期（OS）之间的相关性。基于涉及10231例患者的27项研究，汇总结果显示，PTEN缺失在乳腺癌中比在正常组织中更为常见（OR = 12.15，95% CI = 6.48 - 22.79，P < 0.00001），且PTEN缺失与更大的肿瘤大小（> 2 cm，OR = 0.62，95% CI = 0.48 - 0.82，P = 0.0006）、淋巴结转移（OR = 0.61，95% CI = 0.45 - 0.82，P = 0.0001）、更高的TNM分期（III - IV期，OR = 0.55，95% CI = 0.35 - 0.86，P = 0.009）、低分化（OR = 0.37，95% CI = 0.24 - 0.59，P < 0.0 < 0.0001）以及高侵袭性的三阴性表型（OR = 1.62，95% CI = 1.23 - 2.12，P = 0.0005）显著相关。此外，PTEN缺失的患者DFS和OS显著更差（HR = 1.63，95% CI = 1.04 - 2.22，P < 0.00001；HR = 1.41，95% CI = 1.08 - 1.73，P < 0.0001）。总之，PTEN缺失可能预示着乳腺癌患者的行为更具侵袭性且预后更差。
