Cyclin E的表达和乳腺癌的预后的meta分析

背景与目的：多个临床试验分析了cyclin E与乳腺癌预后的关系，但结果并不一致。本研究对已发表的相关临床试验结果进行再分析，从而探讨肿瘤组织的细胞周期素E（cyclin E）的表达水平是否是乳腺癌的预后因素。方法：检索PubMed以及CBMDisc数据库中研究cyclinE表达与乳腺癌预后关系的文献，使用meta分析的方法分析cyclinE是否为乳腺癌的预后因素。结果：共有13篇符合要求的文献，包括患者的总数为2644人。各个研究之间在病例选择、随访时间、辅助治疗、检测方法以及表达水平的判定标准等方面存在明显的差异。合并的单因素及多因素分析结果显示，高cyclinE水平患者的无复发生存率（RFS）的危险比（HR）分别为2．26（95％CI：1．41—3．61）和1．72（95％CI：0．95—3．10）；高cyclinE水平患者的总生存率（OS）／乳腺癌相关生存率（BCSS）的HR分别为2．74（95％CI：2．22-3．39）和2．86（95％CI：1．85-4．41）。在淋巴结阴性的患者中，合并的高cyclinE水平患者OS的HR为3．40（95％CI：2．20-5．26）。结论：cyclin E可能是乳腺癌OS独立的预后因素，但该结论尚需进一步的大规模临床试验加以验证。

A meta-analysis of cyclin E and its impact on the prognosis of breast cancer patients

Background and purpose:It has been confirmed that cyclin E could accelerate the cell cycles by in vitro studies.Therefore, various studies have investigated the relationship between cyclin E and survival in breast cancer patients.However,the results differed significantly from study to study.To determent whether cyclin E is an independent prognostic factor for breast cancer,we completed a meta-analysis of the published literature.Methods:All data that were associated with the study of the relationship between cyclin E and the prognosis for breast cancer was pooled from PubMed and CBMdisc database.To measure the outcome we used the hazard ratio(HR). The data pooling was performed by Revman 4.2.Results:2644 patients in a total of 13 studies were included in the present meta-analysis.The studies varied greatly in terms of the selection of patients,follow-up period,adjuvant therapy,assessment methods,and cut-off points for cyclin E.The combined HR estimate of relapse-free survival(RFS) for patients with high level of cyclin E was 2.26(95% CI,1.41-3.61) and 1.72(95% CI,0.95-3.10) in univariate and multivariate analysis,respectively.In addition,the combined HR estimate of overall survival(OS) for patients with high level of cyclin E was 2.74(95% CI,2.22-3.39) and 2.86(95% CI 1.85-4.41) in univariate and multivariate analysis,respectively.Among the patients without axillary nodes involvement,the combined HR for OS/BCSS is 3.40 with 95% CI 2.20-5.26(P<0.00001).Conclusions:The high level of cyclin E appears to be an independent prognostic factor to OS of breast cancer patients but not to RFS.Additional studies with large patient number and widely accepted practical methods are required to derive the precise prognostic significance of cyclin E expression in breast caner patients.