Ki-67 labeling index is a predictive marker for a pathological complete response to neoadjuvant chemotherapy in breast cancer: A meta-analysis.
Ki-67 labeling index is a predictive marker for a pathological complete response to neoadjuvant chemotherapy in breast cancer: A meta-analysis.
复制标题
DOI：
10.1097/md.0000000000009384
复制
发表时间：
2017-12
期刊：
影响因子：
1.6
通讯作者：
Zhou Q
中科院分区：
文献类型：
--
作者：
Tao M;Chen S;Zhang X;Zhou Q
新辅助化疗（NCT）后的病理完全缓解（pCR）是治疗获益的强有力指标，并提供了有利长期结局的早期替代品。目前尚不清楚Ki-67作为肿瘤增殖的标志物是否可以作为乳腺癌对NCT反应的预测因子。本荟萃分析的目的是比较接受NCT的具有不同Ki-67标记指数（Ki-67 LI）的乳腺癌患者的pCR率和临床结局。从PubMed、Embase、Clinical Trials、Wanfang和Chinese National Knowledge Infrastructure的电子数据库中检索临床研究，从其成立到2017年7月31日。对符合条件的研究进行荟萃分析，以确定Ki-67 LI是否与接受NCT治疗的乳腺癌患者的pCR率和临床结局相关。使用固定效应模型进行合并分析。两名评审员筛选了所有标题和摘要，并独立评估了所有文章。共纳入36项研究，涉及6793例患者。汇总分析结果显示，与Ki-67 LI低的患者相比，Ki-67 LI高的患者表现出显著更高的pCR率（比值比[OR]= 3.94，95%置信区间[CI]：3.33 - 4.67，P <.001），但无复发生存率更差（OR = 1.99，95% CI：1.39 - 2.85，P <.001），但客观肿瘤缓解率无显著差异。 本文报告的荟萃分析表明，在接受NCT的乳腺癌患者中，治疗前Ki-67 LI与pCR相关。需要更多的III期随机临床试验来证实我们的发现。
Supplemental Digital Content is available in the text A pathological complete response (pCR) after neoadjuvant chemotherapy (NCT) is a strong indicator of the benefit of therapy and presents an early surrogate for a favorable long-term outcome. It remains unclear whether Ki-67, a marker for tumor proliferation, can function as a predictor of the response to NCT in breast cancer. The objective of this meta-analysis was to compare the pCR rate and clinical outcomes in breast cancer patients with different Ki-67 labeling indexes (Ki-67 LI) who received NCT. Clinical studies were retrieved from the electronic databases of PubMed, Embase, Clinical Trials, Wanfang, and the Chinese National Knowledge Infrastructure, from their inception to July 31, 2017. Meta-analysis was performed on pool eligible studies to determine whether Ki-67 LI was associated with the pCR rate and clinical outcomes of breast cancer patients who were treated with NCT. Pooled analyses were performed using fixed effects models. Two reviewers screened all titles and abstracts and independently assessed all articles. A total of 36 studies involving 6793 patients were included in the meta-analysis. Pooled analysis results revealed that patients with high Ki-67 LI exhibited significantly higher pCR rates (odds ratio [OR] = 3.94, 95% confidence interval [CI]: 3.33–4.67, P <.001) but poorer relapse-free survival (OR = 1.99, 95% CI: 1.39–2.85, P <.001) than those with low Ki-67 LI, but there was no significant difference in objective tumor response rate. The meta-analysis reported here demonstrates that pretherapeutic Ki-67 LI is associated with pCR in breast cancer patients undergoing NCT. More phase III randomized clinical trials will be required to confirm our findings.