The Prognostic Role of Androgen Receptor in Patients with Early-Stage Breast Cancer: A Meta-analysis of Clinical and Gene Expression Data
The Prognostic Role of Androgen Receptor in Patients with Early-Stage Breast Cancer: A Meta-analysis of Clinical and Gene Expression Data
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DOI：
10.1158/1078-0432.ccr-16-0979
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发表时间：
2017-06-01
影响因子：
11.5
通讯作者：
Sotiriou, Christos
中科院分区：
文献类型：
--
作者：
Bozovic-Spasojevic, Ivana;Zardavas, Dimitrios;Sotiriou, Christos
目的：雄激素受体（AR）的表达已被观察到约70%的乳腺癌患者，但其预后作用仍然uncertainted.Experimental设计：为了评估AR表达在早期乳腺癌的预后作用，我们进行了荟萃分析的研究，评估AR在蛋白质和基因表达水平对无病生存期（DFS）和/或总生存期（OS）的影响。通过使用MeSH术语“乳腺肿瘤”和“雄激素受体”对电子数据库进行系统评价，确定合格的研究，并在基于REMARK标准进行定性评估后进行选择。一个汇集的基因表达分析35个公开的微阵列数据集也进行了早期乳腺癌患者的基因表达和临床outcome data.Results：22的33个合格的临床荟萃分析研究，包括10,004例患者，被认为是可评价的定性评估后，为当前的研究。在所有乳腺癌患者中，通过IHC定义的AR阳性与DFS改善[多变量（M）分析，HR 0.46; 95%置信区间（CI）0.37-0.58，P < 0.001]和OS更好[M-HR 0.53; 95% CI，0.38-0.73，P < 0.001]相关。包括7，220名患者的35个数据集符合汇总基因表达分析的条件。高AR mRNA水平被发现赋予积极的预后总体而言，DFS（HR 0.82; 95% CI 0.72-0.92; P = 0.0007）和OS（HR 0.84; 95% CI，0.75-0.94; P = 0.02）仅在单变量分析中。我们的分析在临床和基因表达分析中包括的17，000多名早期乳腺癌女性中进行，表明AR阳性与良好的临床结果相关。(C)2016年AACR。
Purpose: Androgen receptor (AR) expression has been observed in about 70% of patients with breast cancer, but its prognostic role remains uncertain.Experimental Design: To assess the prognostic role of AR expression in early-stage breast cancer, we performed a meta-analysis of studies that evaluated the impact of AR at the protein and gene expression level on disease-free survival (DFS) and/or overall survival (OS). Eligible studies were identified by systematic review of electronic databases using the MeSH-terms "breast neoplasm" and "androgen receptor" and were selected after a qualitative assessment based on the REMARK criteria. A pooled gene expression analysis of 35 publicly available microarray data sets was also performed from patients with early-stage breast cancer with available gene expression and clinical outcome data.Results: Twenty-two of 33 eligible studies for the clinical meta-analysis, including 10,004 patients, were considered as evaluable for the current study after the qualitative assessment. AR positivity defined by IHC was associated with improved DFS in all patients with breast cancer [multivariate (M) analysis, HR 0.46; 95% confidence interval (CI) 0.37-0.58, P < 0.001] and better OS [M-HR 0.53; 95% CI, 0.38-0.73, P < 0.001]. Thirty-five datasets including 7,220 patients were eligible for the pooled gene expression analysis. High AR mRNA levels were found to confer positive prognosis overall in terms of DFS (HR 0.82; 95% CI 0.72-0.92; P = 0.0007) and OS (HR 0.84; 95% CI, 0.75-0.94; P = 0.02) only in univariate analysis.Conclusions: Our analysis, conducted among more than 17,000 women with early-stage breast cancer included in clinical and gene expression analysis, demonstrates that AR positivity is associated with favorable clinical outcome. (C) 2016 AACR.