哺乳动物雷帕霉素靶蛋白的表达及其与乳腺癌预后关系的Meta分析

目的：探讨哺乳动物雷帕霉素靶蛋白（mTOR）的表达及其与乳腺癌预后的关系，为mTOR抑制剂靶向治疗乳腺癌提供循证医学证据。方法：计算机检索PubMed、EMBase、Cochrane Library、ISI Web of Science和中国知网等数据库2015年12月24日之前的文献，收集mTOR表达与乳腺癌预后关系的研究，主要结局指标包含无病生存期（DFS）、总生存期（OS）；以风险比（HR）为效应量，各效应量以95%可信区间（CI）表示，采用STATA 12.0统计软件进行Meta分析。结果：纳入7项队列研究，共1758例患者。Meta分析，mTOR阳性表达乳腺癌患者发生复发和转移的风险是mTOR阴性表达患者的2.05倍（HR = 2.05，95% CI：1.01~4.13，P = 0.003）；mTOR阳性表达乳腺癌患者发生死亡的风险是mTOR阴性表达患者的2.63倍（HR = 2.63，95% CI：1.45~4.80，P = 0.736）。结论：mTOR表达阳性明显增加乳腺癌患者复发转移及死亡风险。

Expression of mTOR and its relationship with prognosis of breast cancer:a Meta-analysis

Objective:To explore the expression of mammalian target of rapamycin (mTOR)and its relationgship with the prognosis of breast cancer,and to provide evidence-based basis for the using of mTOR inhibitor in the treatment of breast cancer.Methods: A systemical literature search was conducted based on the following databases:PubMed,EMBbase,Cochrane Library,ISI Web of Science,and CNKI up to November 24,2015.The outcome measures were hazard ratio (HR)with 95% confidence interval (CI) for the association between the mTOR expression and the prognosis of patients with breast cancer.The primary end points including disease-free survival (DFS ), and overall survival (OS ). STATA 12.0 was used to conduct the statistical analysis. Results:A total of seven cohort studies,1 758 patients were included. The risk of recurrence and metastasis of the breast cancer patients with positive expression of mTOR was 2.05 times of the patients with negative expression of mTOR (HR= 2.05, 95% CI: 1.01 - 4.13,P = 0.003);the risk of death in the breast cancer patients with positive expression of mTOR was 2.63 times of the patients with negative expression of mTOR (HR = 2.63, 95%CI:1.45-4.80,P = 0.736).Conclusion:The positive expression of mTOR can significantly increase the recurrence,metastasis and death risk of the patients with breast cancer.