中国乳腺癌妇女表皮生长因子受体-2表达的Meta分析

目的:利用循证医学的研究方法揭示表皮生长因子受体-2(cerbB-2)在中国妇女乳腺癌患者中的表达规律,探讨cerbB-2基因突变与预后的关系,为临床判断乳腺癌预后、实现乳腺癌的规范化和个体化治疗提供依据.方法:收集过去10年国内发表的有关cerbB-2与乳腺癌的文献,按照一定的入排标准将研究方法相似的文献归类整理,原始数据汇总后进行Meta分析和统计处理.结果:cerbB-2在中国乳腺癌妇女中的阳性表达率平均为50%,95%可信区间是48%～54%;cerbB-2表达阳性与淋巴结转移、术后复发、生存时间相关性较强,相对危险度分别为1.71,2.14和2.32;肿瘤大小、组织学分级、临床分期和病理类型与cerbB-2表达显著相关,而年龄与cerbB-2表达无关;cerbB-2对于判断预后有较好的特异度和敏感度,与临床预后有较好的相关性.结论:cerbB-2表达作为独立的分子标志物在一定程度上反映了乳腺癌的生物学特性,可以作为判断预后及规范化和个体化治疗的可靠指标.

Expression of epidermal growth factor receptor-2 in Chinese breast cancer patients: a meta-analysis

Objective:To study the expression of cerbB-2 and its clinical biology value in Chinese breast cancer patients by evidence based medical analysis; Methods:All the published studies about cerbB-2 and breast cancer for the last 10 years were reviewed and standard techniques of meta-analysis to combined with the results of these studies were used to produce a more precise estimate of the prognostic significance expression of cerbB-2. Results:The mean of cerbB-2 positive expression was 50% (95% confidence interval 48%-54%), cerbB-2 positive expression was related with node metastasis, recurrence after surgery and survival time; the RR values were 1.71, 2. 14 and 2. 32 respectively; tumor size, nuclear grade and pathology type were also the important factors that were related with the expression of cerbB-2, while the expression was not related with age; cerbB-2 was a special and sensitive prognostic factor for breast cancer. Conclusion:cerbB-2 can be used as an independent molecular marker for definitive prognosis of breast cancer, as well as a reliable marker for choice of standard and individual therapy.