乙醛脱氢酶1在乳腺癌组织中的表达及其临床意义的Meta分析

Clinical significance of ALDH1 expression in breast cancer:a Meta analysis

目的系统评价乙醛脱氢酶1（ALDH1）在乳腺癌中的表达及其临床意义。方法计算机检索PubMed及Web of Knowledge、CBM、CNKI、万方数据,检索时限从建库至2015年12月,纳入关于ALDH1蛋白表达与乳腺癌临床病理特征相关的病例对照研究的文章,按照纳入和排除标准筛选文献、提取资料并进行质量评价,使用RevMan5.2软件进行Meta分析。结果共纳入9项研究,其中乳腺癌组615例,对照组160例。Meta分析结果显示：ALDH1阳性表达在乳腺癌组明显高于对照组（OR=12.90,95%CI 7.28~22.86,P〈0.01）,乳腺癌组织学Ⅰ~Ⅱ级与Ⅲ级比较差异有统计学意义（OR=0.31,95%CI 0.20~0.49,P〈0.01）,ALDH1阳性表达组的5年生存率低于阴性组,差异有统计学意义（OR=0.23,95%CI 0.10~0.49）,P=0.000 2）,在不同临床分期、肿块大小、淋巴结转移、月经状态以及HER-2状态等方面ALDH1的表达差异无统计学意义（P〉0.05）。结论 ALDH1蛋白高表达与乳腺癌的发生及乳腺癌的组织学分级相关,其高表达可能对乳腺癌患者的5年生存率产生影响,从而可能成为判断预后的指标。

Objective To systematically review the expression and clinical significance of ALDHl in breast cancer.Methods Searches in the databases such as PubMed,Web of Knowledge,CBM,CNKI and Wanfang Data were performed to collect case-control studies about the association between the ALDH1 expression and breast cancer.Reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data,and assessed the methodological quality of the included studies,and then RevMan 5.2 soft ware was used for meta analysis.Results Nine case-control studies involving 615 patients were included.The results of the meta-analyses showed that there was significant difference of ALDH1 expression in the following comparison：breast cancer tissues vs.normal breast tissues（OR = 12.90,95%CI7.28 to 22.86,P 0.01）,Histological grade Ⅰ-Ⅱ vs.Histological grade 1（OR = 0.31,95%CI 0.20 to 0.49,P 0.01）.There was significant difference of ALDH1 positive patients had low 5-year overall survival compared with ALDHl-negative patients（OR =0.23,95%CI 0.10 to 0.49,P =0.000 2）.While no significant difference was found in clinical stage,tumor size,lymph node metastasis,menopausal status and HER-2 status.Conclusion Higher ALDHl expression might be associated with breast cancer,its histological grade,and low 5-year overall survival.It can be used as a factor in judging the prognosis of breast cancer.