bcl-2与p53的表达对女性乳腺癌新辅助化学疗法影响的Meta分析

A Meta-analysis of bcl-2 and p53 Expression in Breast Cancer and Its Relation to Neoadjuvant Chemotherapy

目的评价凋亡相关基因bcl-2、p53的表达与乳腺癌新辅助化学疗法(化疗)疗效的关系。方法计算机检索Cochrane、Pubmed、Embase、中国知网、万方、维普等数据库,2003年4月-2013年4月bcl-2、p53蛋白与乳腺癌新辅助化疗的病例对照研究,应用RevMan 4.2统计软件进行定量分析。结果共纳入15篇病例对照研究,bcl-2与乳腺癌新辅助化疗6篇,治疗有效279例,其中bcl-2表达阳性159例;治疗无效115例,其中bcl-2表达阳性57例。p53与乳腺癌新辅助化疗13篇,治疗有效679例,其中p53表达阳性249例;治疗无效341例,其中p53表达阳性195例。Meta分析结果显示,bcl-2表达的阳性率与乳腺癌新辅助化疗疗效无统计学意义[OR=1.40,95%CI(0.89,2.18),P=0.14],而p53表达的阳性率与乳腺癌新辅助化疗疗效有统计学意义[OR=0.46,95%CI(0.26,0.80),P=0.007]。结论 p53可以作为乳腺癌新辅助化疗疗效敏感性的一个指标,对乳腺癌新辅助化疗有提示作用。

Objective To analyze the correlation between bcl-2, p53 expression in breast cancer and clinical response to neoadjuvant chemotherapy. Methods The databases of Cochrane, PubMed, Embase, CNKI, WanFang, VIP were searched from April 2003 to April 2013 for case-control studies on the correlation of bcl-2, p53 protein expression in breast cancer and clinical response to neoadjuvant chemotherapy. The data were quantitatively analyzed by RevMan 4.2 software. Results Fifteen case-control studies were selected based on our inclusion and exclusion standards. There were six studies on bcl-2 expression in breast cancer and clinical response to neoadjuvant chemotherapy, in which 279 cases were in effective group （bcl-2 positive in 159 cases） and 115 cases were in noneffective group （bcl-2 positive in 57 cases）. There were thirteen studies onp53 expression in breast cancer and clinical response to neoadjuvant chemotherapy, in which 679 cases were in effective group （p53 positive in 249 cases） and 341 cases were in noneffective group （1953 positive in 195 cases）. The results of meta-analysis showed that there was no significant difference between the response to neoadjuvant chemotherapy and bcl-2 expression [OR=1.40, 95%CI （0.89, 2.18）, P=0.14]. The effect of neoadjuvant chemotherapy had a significantly negative correlation with p53 expression [OR=0.46, 95%CI （0.26, 0.80）, P=0.007]. Conclusion The p53 expressions are strong prognostic molecular marker that can be a guide for neoadjuvant chemotherapy and prediction of prognosis for patients with breast cancer.