Value of TP53 status for predicting response to neoadjuvant chemotherapy in breast cancer: a meta-analysis.
Value of TP53 status for predicting response to neoadjuvant chemotherapy in breast cancer: a meta-analysis.
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TP53 状态对于预测乳腺癌新辅助化疗反应的价值：一项荟萃分析。
DOI：
10.1371/journal.pone.0039655
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Lu PH
中科院分区：
文献类型：
--
作者：
Chen MB;Zhu YQ;Xu JY;Wang LQ;Liu CY;Ji ZY;Lu PH
关于乳腺癌患者中肿瘤抑制蛋白TP 53过表达和/或TP 53基因突变与新辅助化疗反应之间的关系，许多研究已经得出了不确定的结果。因此，本研究的目的是评估TP 53状态和乳腺癌化疗反应之间的关系。共识别出26项先前发表的合格研究，包括3，476例病例，并纳入本荟萃分析。在接受新辅助化疗的乳腺癌患者中，TP 53状态（TP 53蛋白和/或TP 53基因突变的过表达）与良好的缓解相关（总客观缓解：风险比[RR]= 1.20，95%置信区间[CI]= 1.09-1.33，p<0.001;病理学客观缓解：RR = 1.37，95% CI = 1.20-1.57，p<0.01;总完全缓解：RR = 1.33，95% CI = 1.15-1.53，p<0.001;病理学完全缓解：RR = 1.45，95% CI = 1.25-1.68，p<0.001）。 在进一步的分层分析中，这种相关性也存在于使用蒽环类药物为基础的新辅助化疗的研究中，并且缓解与基因改变之间的相关性强于缓解与免疫组化阳性之间的相关性。本荟萃分析的结果表明，TP 53状态是乳腺癌患者接受新辅助化疗反应的预测因素。需要进一步更大规模和设计良好的前瞻性研究来评估TP 53状态在临床实践中的预测作用。
Numerous studies have yielded inconclusive results regarding the relationship between tumor suppressor protein TP53 overexpression and/or TP53 gene mutations and the response to neoadjuvant chemotherapy in patients with breast cancer. The purpose of the current study was therefore to evaluate the relationship between TP53 status and response to chemotherapy in breast cancer. A total of 26 previously published eligible studies including 3,476 cases were identified and included in this meta-analysis. TP53 status (over expression of TP53 protein and/or TP53 gene mutations) was associated with good response in breast cancer patients who received neoadjuvant chemotherapy (total objective response: risk ratio [RR] = 1.20, 95% confidence interval [CI] = 1.09–1.33, p<0.001; pathological objective response: RR = 1.37, 95% CI = 1.20–1.57, p<0.01; total complete response: RR = 1.33, 95% CI = 1.15–1.53, p<0.001; pathological complete response: RR = 1.45, 95% CI = 1.25–1.68, p<0.001). In further stratified analyses, this association also existed among the studies using anthracycline-based neoadjuvant chemotherapy, and the association between response and the presence of gene alterations was stronger than that between response and immunohistochemistry positivity. The results of the present meta-analysis suggest that TP53 status is a predictive factor for response in breast cancer patients undergoing neoadjuvant chemotherapy. Further larger and well-designed prospective studies are required to evaluate the predictive role of TP53 status in clinical practice.
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