我国HER-2阳性乳腺癌预后影响因素的Meta分析

Prognostic factors for HER-2-positive breast cancer in China: a Meta-analysis

目的：系统评价影响HER-2阳性乳腺癌预后的因素。方法：检索国内公开发表的关于HER-2阳性乳腺癌预后相关的文献,依据纳入标准和排除标准,纳入符合要求的文献,并提取相应观测指标的5年生存率,利用Revman 5.3软件行Meta分析。结果：纳入4篇文献。558例患者纳入研究。各指标5年生存率的Meta结果显示,年龄≥35岁患者优于年龄〈35岁患者（OR=0.01,95%CI=0.01~0.02,P〈0.00001）、无家族史的优于有家族史的患者（OR=0.00,95%CI=0.00~0.00,P〈0.00001）、肿瘤〈5 cm的患者优于肿瘤≥5 cm的患者（OR=14.83,95%CI=1.03~212.53,P=0.05）、无淋巴结转移的患者优于有淋巴结转移的患者（OR=0.47,95%CI=0.27~0.82,P=0.007）、组织学分级为I、II级的患者优于分级为III级的患者（OR=2.84,95%CI=1.63~4.97,P=0.0002）、病理分型为其他癌的患者优于病理分型为浸润性导管癌的患者（OR=35.5,95%CI=21.71~58.03,P〈0.00001）;绝经状态对患者预后无明显影响（OR=0.64,95%CI=0.26~1.59,P=0.34）。结论：年龄、家族史、肿瘤大小、淋巴结转移、组织学分级、病理分型与HER-2阳性乳腺癌预后有关。绝经状态对预后的影响有待进一步证明。

Objective： To systematically assess the factors that inl uence the prognosis of HER-2-positive breast cancer. Methods： Publicly published domestic studies regarding the prognosis of HER-2-positive breast cancer were searched, and the eligible studies were selected based on the inclusion and exclusion criteria, and then the 5-year survival rates for dif erent observational factors were extracted and Meta-analysis was performed by Rev Man 5.3 sot ware.Results： A total of 4 studies with 558 patients were included. Results of Meta-analysis for dif erent observational factors showed that the 5-year survival rate in patients ≥35 years of age was bet er than that in those 〈35 years ofage（OR=0.01, 95% CI=0.01–0.02, P〈0.00001）, in patients without family history was bet er than those with a family history（OR=0.00, 95% CI=0.00–0.00, P〈0.00001）, in patients with tumor size 〈 5 cm was bet er that those with tumor size ≥5 cm（OR=14.83, 95% CI=1.03–212.53, P=0.05）, in patients without lymph node metastasis was bet er than in those with lymph node metastasis（OR=0.47, 95% CI=0.27–0.82, P=0.007）, in patients with histological grade I or II was better than in those with histological grade III（OR=2.84, 95% CI=1.63–4.97, P=0.0002）, and in patients with other pathological types was bet er than in those with invasive ductal carcinoma（OR=35.5, 95% CI=21.71–58.03, P〈0.00001）; the menopausal status had no signii cant inl uence on prognosis of the patients（OR=0.64, 95% CI=0.26–1.59, P=0.34）. Conclusion： Age, family history, tumor size, lymph node metastasis, histological grade and pathological type are associated with the prognosis of HER-2-positive breast cancer, but the influence of menopausal status on prognosis remains to be identii ed.