Numprasit Warapan, Yangngam Supaporn, Prasopsiri Jaturawitt, Quinn Jean A, Edwards Joanne, Thuwajit Chanitra
Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
School of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom.
Front Med (Lausanne). 2023 Mar 17;10:1087270. doi: 10.3389/fmed.2023.1087270. eCollection 2023.
Tumoral hypoxia is associated with aggressiveness in many cancers including breast cancer. However, measuring hypoxia is complicated. Carbonic anhydrase IX (CAIX) is a reliable endogenous marker of hypoxia under the control of the master regulator hypoxia-inducible factor-1α (HIF-1α). The expression of CAIX is associated with poor prognosis in many solid malignancies; however, its role in breast cancer remains controversial.
The present study performed a meta-analysis to evaluate the correlation between CAIX expression and disease-free survival (DFS) and overall survival (OS) in breast cancer.
A total of 2,120 publications from EMBASE, PubMed, Cochrane, and Scopus were screened. Of these 2,120 publications, 272 full texts were reviewed, and 27 articles were included in the meta-analysis. High CAIX was significantly associated with poor DFS (HR = 1.70, 95% CI = 1.39-2.07, < 0.00001) and OS (HR = 2.02, 95% CI 1.40-2.91, = 0.0002) in patients with breast cancer. When stratified by subtype, the high CAIX group was clearly associated with shorter DFS (HR = 2.09, 95% CI =1.11-3.92, = 0.02) and OS (HR = 2.50, 95% CI =1.53-4.07, = 0.0002) in TNBC and shorter DFS in ER breast cancer (HR = 1.81 95% CI =1.38-2.36, < 0.0001).
High CAIX expression is a negative prognostic marker of breast cancer regardless of the subtypes.
肿瘤缺氧与包括乳腺癌在内的许多癌症的侵袭性相关。然而，测量缺氧情况较为复杂。碳酸酐酶IX（CAIX）是在主要调节因子缺氧诱导因子-1α（HIF-1α）控制下的一种可靠的内源性缺氧标志物。CAIX的表达与许多实体恶性肿瘤的预后不良相关；然而，其在乳腺癌中的作用仍存在争议。
本研究进行了一项荟萃分析，以评估CAIX表达与乳腺癌无病生存期（DFS）和总生存期（OS）之间的相关性。
共筛选了来自EMBASE、PubMed、Cochrane和Scopus的2120篇出版物。在这2120篇出版物中，对272篇全文进行了审查，27篇文章纳入荟萃分析。乳腺癌患者中，高CAIX表达与较差的DFS（HR = 1.70，95%CI = 1.39 - 2.07，P < 0.00001）和OS（HR = 2.02，95%CI 1.40 - 2.91，P = 0.0002）显著相关。按亚型分层时，高CAIX组在三阴性乳腺癌（TNBC）中与较短的DFS（HR = 2.09，95%CI = 1.11 - 3.92，P = 0.02）和OS（HR = 2.50，95%CI = 1.53 - 4.07，P = 0.0002）明显相关，在雌激素受体（ER）阳性乳腺癌中与较短的DFS（HR = 1.81，95%CI = 1.38 - 2.36，P < 0.0001）相关。
无论亚型如何，高CAIX表达都是乳腺癌的不良预后标志物。
