Meta-analysis confirms BCL2 is an independent prognostic marker in breast cancer
Autor: | Paul D.P. Pharoah, Carlos Caldas, Mark Webber, Grace Callagy |
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Přispěvatelé: | Pharoah, Paul [0000-0001-8494-732X], Caldas, Carlos [0000-0003-3547-1489], Apollo - University of Cambridge Repository |
Jazyk: | angličtina |
Předmět: |
Oncology
p53 Pathology Cancer Research Multivariate analysis carcinomas term-follow-up Surgical oncology skin and connective tissue diseases Tissue microarray Incidence apoptosis adjuvant therapy predict survival Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Prognosis Proto-Oncogene Proteins c-bcl-2 Meta-analysis Predictive value of tests Female Research Article Adult medicine.medical_specialty multivariate-analysis tumor Breast Neoplasms lcsh:RC254-282 Risk Assessment Sensitivity and Specificity Disease-Free Survival Breast cancer Age Distribution Predictive Value of Tests Internal medicine expression medicine Adjuvant therapy Biomarkers Tumor Genetics Humans neoplasms Survival analysis Aged tissue microarray business.industry medicine.disease Survival Analysis business |
Zdroj: | BMC Cancer BMC Cancer, Vol 8, Iss 1, p 153 (2008) |
ISSN: | 1471-2407 |
DOI: | 10.1186/1471-2407-8-153 |
Popis: | Background A number of protein markers have been investigated as prognostic adjuncts in breast cancer but their translation into clinical practice has been impeded by a lack of appropriate validation. Recently, we showed that BCL2 protein expression had prognostic power independent of current used standards. Here, we present the results of a meta-analysis of the association between BCL2 expression and both disease free survival (DFS) and overall survival (OS) in female breast cancer. Methods Reports published in 1994–2006 were selected for the meta-analysis using a search of PubMed. Studies that investigated the role of BCL2 expression by immunohistochemistry with a sample size greater than 100 were included. Seventeen papers reported the results of 18 different series including 5,892 cases with an average median follow-up of 92.1 months. Results Eight studies investigated DFS unadjusted for other variables in 2,285 cases. The relative hazard estimates ranged from 0.85 – 3.03 with a combined random effects estimate of 1.66 (95%CI 1.25 – 2.22). The effect of BCL2 on DFS adjusted for other prognostic factors was reported in 11 studies and the pooled random effects hazard ratio estimate was 1.58 (95%CI 1.29–1.94). OS was investigated unadjusted for other variables in eight studies incorporating 3,910 cases. The hazard estimates ranged from 0.99–4.31 with a pooled estimate of risk of 1.64 (95%CI 1.36–2.0). OS adjusted for other parameters was evaluated in nine series comprising 3,624 cases and the estimates for these studies ranged from 1.10 to 2.49 with a pooled estimate of 1.37 (95%CI 1.19–1.58). Conclusion The meta-analysis strongly supports the prognostic role of BCL2 as assessed by immunohistochemistry in breast cancer and shows that this effect is independent of lymph node status, tumour size and tumour grade as well as a range of other biological variables on multi-variate analysis. Large prospective studies are now needed to establish the clinical utility of BCL2 as an independent prognostic marker. |
Databáze: | OpenAIRE |
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