Department of Pathology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Department of Medical Oncology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Medicine (Baltimore). 2024 Oct 4;103(40):e40013. doi: 10.1097/MD.0000000000040013.
Breast cancer is a heterogeneous condition with variations in histopathological, genomic, and biological characteristics. Although clinicopathological prognostic factors and gene expression profiles are commonly used to guide treatment decisions in patients with breast cancer, there is still a need for new prognostic markers. One potential marker is survivin, a protein belonging to the apoptosis inhibitor family. However, studies examining the relationship between survivin and prognosis in breast cancer have yielded inconsistent results. This study aimed to evaluate the impact of survivin expression on the prognosis of breast cancer patients through a meta-analysis.
Studies evaluating survivin expression were sourced from the PubMed, Embase, and Cochrane databases. We conducted a meta-analysis based on full-text articles that evaluated the relationship between survivin expression and survival by immunochemistry or polymerase chain reaction. The studies were initially divided into 2 groups based on the evaluation of overall survival (OS) and disease-free survival (DFS). Subsequently, each group was further categorized according to the method used to detect survivin expression. Statistical analyses for this study were conducted using Stata and JAMOVI.
After screening with keywords, we identified 24 retrospective studies evaluating OS and 15 retrospective studies evaluating DFS, which were included in the analysis. We found that the studies in the meta-analysis were not heterogeneous, and this remained consistent when categorizing the groups by survivin expression detection. Survivin expression was associated with OS (HR 1.23, 95% CI 0.81-1.65) and DFS (HR 0.89, CI 0.42-1.36), indicating poor prognosis. This significant relationship between survivin expression and survival persisted when the studies were categorized by the detection method, either immunohistochemistry or polymerase chain reaction.
In this study, we evaluated the prognostic significance of survivin expression in patients with breast cancer through a meta-analysis. These results support the use of survivin expression as a prognostic marker in breast cancer, potentially guiding treatment decisions.
乳腺癌是一种具有组织病理学、基因组和生物学特征异质性的疾病。虽然临床病理预后因素和基因表达谱常用于指导乳腺癌患者的治疗决策，但仍需要新的预后标志物。一种潜在的标志物是生存素，它是凋亡抑制剂家族的一种蛋白质。然而，研究生存素与乳腺癌预后之间的关系得出的结果并不一致。本研究旨在通过荟萃分析评估生存素表达对乳腺癌患者预后的影响。
从 PubMed、Embase 和 Cochrane 数据库中检索评估生存素表达的研究。我们对评估生存素表达与免疫化学或聚合酶链反应生存关系的全文文章进行荟萃分析。这些研究最初根据总体生存（OS）和无病生存（DFS）的评估分为 2 组。随后，根据检测生存素表达的方法，将每组进一步分类。本研究的统计分析使用 Stata 和 JAMOVI 进行。
通过关键词筛选，我们确定了 24 项评估 OS 的回顾性研究和 15 项评估 DFS 的回顾性研究，这些研究都包含在分析中。我们发现荟萃分析中的研究没有异质性，当根据生存素表达检测对这些研究进行分类时，这种情况仍然存在。生存素表达与 OS（HR 1.23，95%CI 0.81-1.65）和 DFS（HR 0.89，CI 0.42-1.36）相关，提示预后不良。当根据免疫组织化学或聚合酶链反应检测方法对研究进行分类时，生存素表达与生存之间的显著关系仍然存在。
本研究通过荟萃分析评估了生存素表达在乳腺癌患者中的预后意义。这些结果支持将生存素表达作为乳腺癌的预后标志物，可能指导治疗决策。
