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浸润性微乳头状癌与乳腺浸润性导管癌预后的比较:PSM 研究的荟萃分析。

Prognosis of invasive micropapillary carcinoma compared with invasive ductal carcinoma in breast: A meta-analysis of PSM studies.

机构信息

Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.

出版信息

Breast. 2020 Jun;51:11-20. doi: 10.1016/j.breast.2020.01.041. Epub 2020 Jan 29.

Abstract

BACKGROUND

Invasive micropapillary carcinoma (IMPC) is a rare histological subtype of breast cancer. The outcome of IMPC remains controversial; we conducted a meta-analysis of propensity score matching (PSM) studies to evaluate the prognostic difference between IMPC and invasive ductal carcinoma (IDC).

METHODS

We searched PubMed, EMBASE and the Cochrane library for PSM studies comparing survival data between IMPC and IDC. The summarized odds ratios (ORs) and 95% confidence interval (95% CI) are calculated by STATA software utilizing fixed-effect or random-effect models, depending on the heterogeneity of the eligible studies.

RESULTS

Eight PSM studies including 2102 IMPC patients are included in the meta-analysis. Compared with IDC, IMPC has a similar overall survival (OS) (estimated OR = 0.87, 95% CI: 0.61-1.25), but a shorter relapse free survival (RFS) (estimated OR = 1.31, 95% CI: 1.06-1.61); the shorter RFS might owe to the significantly higher loco-regional recurrence rate of IMPC (estimated OR = 3.60, 95% CI: 1.99-6.52). Funnel plots and Egger's tests are used to evaluate publication bias and the p value for OS and RFS are 0.036 and 0.564 respectively.

CONCLUSIONS

Our results demonstrate that compared with IDC, IMPC exhibits a similar, even favorite OS, but a shorter RFS; and the shorter RFS might owe to the significantly higher loco-regional recurrence rate of IMPC. These results could contribute to the individualized therapy and follow-up strategies for IMPC patients.

摘要

背景

浸润性微乳头状癌(IMPC)是一种罕见的乳腺癌组织学亚型。IMPC 的预后仍然存在争议;我们进行了一项倾向评分匹配(PSM)研究的荟萃分析,以评估 IMPC 与浸润性导管癌(IDC)之间的预后差异。

方法

我们检索了 PubMed、EMBASE 和 Cochrane 图书馆中比较 IMPC 和 IDC 生存数据的 PSM 研究。使用 STATA 软件汇总优势比(OR)和 95%置信区间(95%CI),具体取决于合格研究的异质性,采用固定效应或随机效应模型。

结果

纳入的 8 项 PSM 研究共纳入 2102 例 IMPC 患者。与 IDC 相比,IMPC 的总生存率(OS)相似(估计 OR=0.87,95%CI:0.61-1.25),但无复发生存率(RFS)较短(估计 OR=1.31,95%CI:1.06-1.61);较短的 RFS 可能归因于 IMPC 的局部区域复发率显著较高(估计 OR=3.60,95%CI:1.99-6.52)。漏斗图和 Egger 检验用于评估发表偏倚,OS 和 RFS 的 p 值分别为 0.036 和 0.564。

结论

我们的结果表明,与 IDC 相比,IMPC 表现出相似的甚至更有利的 OS,但 RFS 较短;较短的 RFS 可能归因于 IMPC 的局部区域复发率显著较高。这些结果可能有助于制定 IMPC 患者的个体化治疗和随访策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/186a/7375573/fbcb0a422c15/gr1.jpg

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