Liu Ya, Huang Jie, Li Wen, Chen Yujuan, Liu Xuejuan, Wang Jing
Department of Breast Surgery, Western China Hospital of Sichuan University, Chengdu, 610041, China.
Department of Rheumatology, Shenzhen Hospital of Peking University, Guangzhou Medical University, Shenzhen, 518000, China.
Oncotarget. 2018 Jan 4;9(16):13060-13067. doi: 10.18632/oncotarget.23962. eCollection 2018 Feb 27.
The prognostic value of signal transducer and activator of transcription 3 (STAT3) and phospho-STAT3 in breast cancer remains controversial in heterogeneous. The objective of this meta-analysis was to evaluate STAT3 and phospho-STAT3 expression on the prognosis of breast cancer patients.
PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Chinese CNKI, and Wan Fang were searched up to 19th June 2017. Studies which investigated the STAT3 or phospho-STAT3 expression of patients with breast cancer on the basis of patient survival data or survival curve were eligible.
This meta-analysis involves 12 studies and 4513 female patients with breast cancer. No clear relationship exists between overall survival (OS) and high expression of STAT3 and p-STAT3 (hazard ratio [HR] = 0.95, 95% confidence interval [CI]: 0.62-1.46, > 0.05). p-STAT3 expression is unrelated to disease-free survival (HR = 0.69, 95% CI: 0.18-2.55, = 0.573). Notably, the pooled effect predicts better breast cancer-specific survival with p-STAT3 overexpression (HR = 0.68, 95% CI: 0.59-0.78, = 30.9%, < 0.001). Results of subgroup analyses show that STAT3 overexpression indicates shorter OS (HR = 1.87, 95% CI: 1.42-2.45, < 0.001) when excluding the heterogeneity test. Meanwhile, p-STAT3-positive patients have a significantly higher OS than their counterparts (HR = 0.72, 95% CI: 0.57-0.91, < 0.01).
Positive STAT3 expression may indicate poor OS. However, p-STAT3, as a potential molecular biomarker for predicting chemotherapeutic effect, appears to have better prognostic value than STAT3.
信号转导与转录激活因子3（STAT3）及磷酸化STAT3（p-STAT3）在乳腺癌中的预后价值在不同研究中仍存在争议。本荟萃分析的目的是评估STAT3和p-STAT3表达对乳腺癌患者预后的影响。
检索截至2017年6月19日的PubMed、Cochrane对照试验中心注册库、Embase、科学网、中国知网和万方数据库。纳入基于患者生存数据或生存曲线研究乳腺癌患者STAT3或p-STAT3表达情况的研究。
本荟萃分析纳入12项研究，共4513例女性乳腺癌患者。总体生存（OS）与STAT3及p-STAT3高表达之间无明显关联（风险比[HR]=0.95，95%置信区间[CI]：0.62-1.46，P>0.05）。p-STAT3表达与无病生存无关（HR=0.69，95%CI：0.18-2.55，P=0.573）。值得注意的是，汇总效应显示p-STAT3过表达可预测更好的乳腺癌特异性生存（HR=0.68，95%CI：0.59-0.78，P=30.9%，P<0.001）。亚组分析结果显示，排除异质性检验后，STAT3过表达提示OS较短（HR=1.87，95%CI：1.42-2.45，P<0.001）。同时，p-STAT3阳性患者的OS显著高于阴性患者（HR=0.72，95%CI：0.57-0.91，P<0.01）。
STAT3阳性表达可能提示OS较差。然而，p-STAT3作为预测化疗效果的潜在分子生物标志物，似乎比STAT3具有更好的预后价值。
