The Role of the PTEN/PI3K/Akt Pathway on Prognosis in Epithelial Ovarian Cancer: AMeta-Analysis
The Role of the PTEN/PI3K/Akt Pathway on Prognosis in Epithelial Ovarian Cancer: AMeta-Analysis
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PTEN/PI3K/Akt 通路对上皮性卵巢癌预后的作用：荟萃分析。
DOI：
10.1634/theoncologist.2013-0333
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发表时间：
2014-05-01
期刊：
影响因子：
5.8
通讯作者：
Wang, Zehua
中科院分区：
文献类型：
--
作者：
Cai, Jing;Xu, Linjuan;Wang, Zehua
PTEN/PI 3 K/Akt信号通路是介导细胞凋亡、代谢、细胞增殖和细胞生长的关键因素，在许多癌症中经常失调。然而，该途径对上皮性卵巢癌（EOC）的预后影响仍然不一致。我们基于个体研究结果进行了荟萃分析，以更准确地评估其在EOC患者中的临床意义。方法.我们检索了1990年1月1日至2013年3月1日期间发表的所有潜在相关研究，这些研究评估了PTEN、PI 3 K和Akt状态与EOC生存率之间的相关性。采用固定效应或随机效应模型（如适用）进行荟萃分析。我们通过漏斗图调查发表偏倚的可能性，并通过I（2）统计量确定异质性。结果11项合格的研究分析了PTEN，5项分析了PI 3 K，11项分析了pAkt。PI 3 K和pAkt高表达与总生存期差相关（OS; PI 3 K的合并校正风险比[HR] = 1.44，95% CI，1.08-1.91; pAkt的HR = 1.60，95% CI，1.26-2.04）。此外，单变量和多变量估计值的荟萃分析均显示，仅高pAkt表达与不良无进展生存期显著相关（PFS;合并未校正HR = 1.24，95% CI，1.10-1.39;合并校正HR = 1.65，95% CI，1.07-2.55）。结论已发表的研究表明，高pAkt表达与EOC患者的OS和PFS差显著相关，但目前可用的证据不足以推荐在临床实践中将PTEN、PI 3 K或Akt用作EOC的预后预测因子。
The PTEN/PI3K/Akt signaling pathway, a key player in mediating apoptosis, metabolism, cell proliferation, and cell growth, is frequently dysregulated in many cancers. However, the pathway's prognostic impact in epithelial ovarian cancer (EOC) is still inconsistent. We performed a meta-analysis based on individual study outcomes to more precisely evaluate its clinical significance in EOC patients. Methods. We searched all potentially relevant studies published between January 1, 1990, and March 1, 2013, that assessed the association between PTEN, PI3K, and Akt status and survival in EOC. Meta-analysis was performed using a fixed-effect or random-effects model as appropriate. We investigated the possibility of publication bias through a funnel plot and identified the heterogeneity by I(2) statistics. Results. Eleven eligible studies were analyzed for PTEN, 5 for PI3K, and 11 for pAkt. High PI3K and pAkt expression was associated with poor overall survival (OS; pooled adjusted hazard ratio [HR] = 1.44, 95% CI, 1.08-1.91 for PI3K; HR = 1.60, 95% CI, 1.26-2.04 for pAkt). In addition, both the meta-analyses of univariate and multivariate estimates showed that only high pAkt expression was significantly associated with poor progression-free survival (PFS; pooled unadjusted HR = 1.24, 95% CI, 1.10-1.39; pooled adjusted HR = 1.65, 95% CI, 1.07-2.55). Conclusion. Published studies suggest that high pAkt expression is significantly associated with poor OS and PFS in EOC patients, but currently available evidence is insufficient to recommend that PTEN, PI3K, or Akt be used as prognostic predictors in EOC in clinical practice.