Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
BMC Cancer. 2023 Oct 19;23(1):1003. doi: 10.1186/s12885-023-11517-7.
N-myc downstream-regulated gene-1 (NDRG1) is well-described as a potent metastasis suppressor, but its role in human breast cancer remains controversial and unclear. Therefore, the present study utilized a systematic review and meta-analysis approach to synthesize the association between NDRG1 protein expression and the aggressive characteristics of breast cancer.
The protocol for the systematic review and meta-analysis was registered on the PROSPERO website (CRD42023414814). Relevant articles were searched for in PubMed, Scopus, Embase, MEDLINE, and Ovid between March 30, 2023, and May 5, 2023. The included studies were critically evaluated using the Joanna Briggs Institute critical appraisal tools. The results from individual studies were qualitatively synthesized using textual narrative synthesis. Using a random-effects model, the pooled log odds ratio of effect estimate was used to look at the link between NDRG1 protein expression and aggressive features of breast cancer, such as tumor grade, tumor stage, metastasis to the axillary lymph nodes, and hormonal receptor status.
A total of 1423 articles were retrieved from the electronic database search, and six studies that met the eligibility criteria were included for synthesis. There was an association between the expression of NDRG1 protein and the status of the axillary lymph nodes (P = 0.01, log Odds Ratio (OR): 0.59, 95% Confidence Interval (CI): 0.13-1.05, I: 24.24%, 292 breast cancer cases with positive axillary lymph nodes and 229 breast cancer cases with negative axillary lymph nodes, 4 studies). NDRG1 protein expression and human epidermal growth factor receptor 2 (Her2) status were found to have a negative relationship (P = 0.01, log OR: -0.76, 95% CI: -1.32-(-0.20), I: 32.42%, 197 breast cancer cases with Her2 positive and 272 breast cancer cases with Her2 negative, 3 studies). No correlation was found between NDRG1 protein expression and tumor grade (P = 0.10), estrogen receptor (ER) status (P = 0.57), or progesterone receptor (PR) status (P = 0.41).
The study concluded that increased NDRG1 protein expression was associated with increased metastasis of the tumor to the axillary lymph node. Additionally, increased NDRG1 protein expression was observed in Her2-negative breast cancer, suggesting its role in both less aggressive and more aggressive behavior depending on breast cancer subtypes. Based on the findings of the meta-analysis, an increase in NDRG1 protein expression was associated with aggressive characteristics of breast cancer.
N- MYC 下游调节基因 1（NDRG1）是一种强有力的转移抑制因子，但它在人类乳腺癌中的作用仍存在争议和不清楚。因此，本研究采用系统评价和荟萃分析的方法来综合 NDRG1 蛋白表达与乳腺癌侵袭性特征之间的关联。
本系统评价和荟萃分析的方案已在 PROSPERO 网站（CRD42023414814）上注册。于 2023 年 3 月 30 日至 2023 年 5 月 5 日，在 PubMed、Scopus、Embase、MEDLINE 和 Ovid 中检索相关文章。使用 Joanna Briggs 研究所的批判性评估工具对纳入的研究进行批判性评估。使用随机效应模型，对个体研究的结果进行定性综合，使用文字叙述性综合方法。观察 NDRG1 蛋白表达与乳腺癌侵袭性特征（如肿瘤分级、肿瘤分期、腋窝淋巴结转移和激素受体状态）之间的关联。
从电子数据库检索中检索到 1423 篇文章，有 6 项符合纳入标准的研究进行了综合分析。NDRG1 蛋白表达与腋窝淋巴结状态之间存在关联（P=0.01，对数优势比（OR）：0.59，95%置信区间（CI）：0.13-1.05，I：24.24%，292 例腋窝淋巴结阳性乳腺癌和 229 例腋窝淋巴结阴性乳腺癌，4 项研究）。NDRG1 蛋白表达与人类表皮生长因子受体 2（Her2）状态呈负相关（P=0.01，对数 OR：-0.76，95%CI：-1.32-（-0.20），I：32.42%，197 例 Her2 阳性乳腺癌和 272 例 Her2 阴性乳腺癌，3 项研究）。NDRG1 蛋白表达与肿瘤分级（P=0.10）、雌激素受体（ER）状态（P=0.57）或孕激素受体（PR）状态（P=0.41）无相关性。
本研究得出结论，NDRG1 蛋白表达增加与肿瘤向腋窝淋巴结转移增加有关。此外，在 Her2 阴性乳腺癌中观察到 NDRG1 蛋白表达增加，提示其在不同乳腺癌亚型中既具有侵袭性，也具有非侵袭性的作用。基于荟萃分析的结果，NDRG1 蛋白表达增加与乳腺癌的侵袭性特征有关。
