A Meta-analysis of bcl-2 and p53 Expression in Breast Cancer and Its Relation to Neoadjuvant Chemotherapy_West China Medical Journal

Authors：

CAO Yuan ^1,2 , FANG Yue ^1,2 , QIN Rong ¹ , SHEN Huiling ¹ , ZHU Xiaolan ² , LI Hao ² ,  XU Wenlin. ²

1. Department of Oncology, Affiliated People’s Hospital; 2. Department of Central Laboratory, Affiliated Fourth People’s Hospital; Jiangsu University, Zhenjiang, Jiangsu 212001, P. R. China;

Corresponding?author：

XU Wenlin., Email: caoyuan-cy@126.com

Keywords：

基因，bcl-2; 基因，p53; 乳腺癌; 新輔助化療; Meta分析

DOI：

10.7507/1002-0179.20130529

Video：

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目的　評價凋亡相關基因bcl-2、p53的表達與乳腺癌新輔助化學療法（化療）療效的關系。方法　計算機檢索Cochrane、Pubmed、Embase、中國知網、萬方、維普等數據庫，2003年4月－2013年4月bcl-2、p53蛋白與乳腺癌新輔助化療的病例對照研究，應用RevMan 4.2統計軟件進行定量分析。結果　共納入15篇病例對照研究，bcl-2與乳腺癌新輔助化療6篇，治療有效279例，其中bcl-2表達陽性159例；治療無效115例，其中bcl-2表達陽性57例。p53與乳腺癌新輔助化療13篇，治療有效679例，其中p53表達陽性249例；治療無效341例，其中p53表達陽性195例。Meta分析結果顯示，bcl-2表達的陽性率與乳腺癌新輔助化療療效無統計學意義[OR=1.40，95%CI（0.89，2.18），P=0.14]，而p53表達的陽性率與乳腺癌新輔助化療療效有統計學意義[OR=0.46，95%CI（0.26，0.80），P=0.007]。結論　p53可以作為乳腺癌新輔助化療療效敏感性的一個指標，對乳腺癌新輔助化療有提示作用。

Citation： CAO Yuan,FANG Yue,QIN Rong,SHEN Huiling,ZHU Xiaolan,LI Hao,XU Wenlin.. A Meta-analysis of bcl-2 and p53 Expression in Breast Cancer and Its Relation to Neoadjuvant Chemotherapy. West China Medical Journal, 2013, 28(11): 1671-1674. doi: 10.7507/1002-0179.20130529 Copy

1.	Connolly RM, Stearns V. Current approaches for neoadjuvant chemotherapy in breast cancer[J/OL]. Eur J Pharmacol, 2013[2013-04-28]. http://dx.doi.org/10.1016/j.ejphar.2013.02.057.
2.	Charfare H, Limongelli S, Purushotham AD. Neoadjuvant chemotherapy in breast cancer[J]. Br J Surg, 2005, 92(1): 14-23.
3.	Buchholz TA, Hunt KK, Whitman GJ, et al. Neoadjuvant chemotherapy for breast carcinoma: multidisciplinary considerations of benefits and risks[J]. Cancer, 2003, 98(6): 1150-1160.
4.	Linjawi A, Kontogiannea M, Halwani F, et al. Prognostic significance of p53, bcl-2, and Bax expression in early breast cancer[J]. J Am Coll Surg, 2004, 198(1): 83-90.
5.	Cecka F, Hornychova H, Melichar B, et al. Expression of bcl-2 in breast cancer: correlation with clinicopathological characteristics and survival[J]. Acta Medica (Hradec Kralove), 2008, 51(2): 107-112.
6.	Yu B, Sun X, Shen HY, et al. Expression of the apoptosis-related genes BCL-2 and BAD in human breast carcinoma and their associated relationship with chemosensitivity[J]. J Exp Clin Cancer Res, 2010, 29: 107.
7.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具[J]. 中國循證心血管醫學雜志, 2011, 8(4): 297-299.
8.	趙迎春, 李勇, 朱永云, 等. ER、PR、p53和Bcl-2的表達變化在乳腺癌新輔助化療中的意義[J]. 現代腫瘤醫學, 2011, 19(10): 2017-2020.
9.	阮永威, 金星, 馬宏巖, 等. 乳腺癌P53, ki-67和Bcl-2的表達與新輔助化療的關系[J]. 中國普通外科雜志, 2006, 15(4): 247-249.
10.	徐勝前, 張春輝, 尤其俋. 乳腺癌新輔助化療Bcl-2和生存素的表達及其與化療反應的相關性[J]. 江蘇醫藥, 2007, 33(3): 236-238.
11.	姜大慶, 趙林, 龍飛, 等. 乳腺癌新輔助化療中Ki-67、Bcl-2及AI的表達與化療效果關系的研究[J]. 中國實用外科雜志, 2005, 25(4): 230-231.
12.	Tiezzi DG, De Andrade JM, Candido D, et al. Apoptosis induced by neoadjuvant chemotherapy in breast cancer[J]. Pathology, 2006, 38(1): 21-27.
13.	Fernández-Sánchez M, Gamboa-Dominguez A, Uribe N, et al. Clinical and pathological predictors of the response to neoadjuvant anthracycline chemotherapy in locally advanced breast cancer[J]. Med Oncol, 2006, 23(2): 171-183.
14.	劉瑞磊, 呂偉明, 衛洪波, 等.中華普通外科學文獻稿約[J/OL]. 中華普通外科學文獻·電子版, 2013, 2(2): 162-164.
15.	凡慶東, 姜軍, 楊新華, 等. 乳腺癌p53、cerbB-2表達與TE方案新輔助化療療效的關系[J]. 重慶醫科大學學報, 2007, 32(10): 1059-1061.
16.	林其聲, 施雄文, 徐書楷, 等. 新輔助化療對乳腺癌ki67、cox-2、p53表達的影響及其臨床意義[J]. 中國當代醫藥, 2009, 16(24): 13-14.
17.	匡忠生, 謝宇暉, 何玉萍, 等. 乳腺癌新輔助化療療效與ER、PR、p53及HER2表達的關系[J]. 中國醫藥指南, 2012, 10(25): 401-403.
18.	屈明, 趙建玲, 薛軍, 等. 乳腺癌腫瘤生物學因子檢測對新輔助化療方案選擇的指導作用[J]. 山東醫藥, 2009, 49(48): 59-61.
19.	楊海松, 黃建軍, 毛大華, 等. 新輔助化療對乳腺癌雌激素受體和P53基因及人表皮生長因子受體-2的影響及意義[J]. 中國全科醫學, 2011, 14(12): 1292-1295.
20.	王曉蘭, 陳波, 姚凡, 等. HER-2、p53的表達對乳腺癌蒽環類新輔助化療療效的影響[J]. 山東醫藥, 2008, 48(32): 1-3.
21.	李艷萍, 張斌, 喻衛紅, 等. Bcl-2、C-erbB2和PCNA表達與乳腺癌新輔助治療療效關系的研究[J]. 中國腫瘤臨床與康復, 2007, 14(1): 8-10.
22.	廖丹, 姚和瑞, 陳煥清. 表皮生長因子受體-2和P53及Ki67的表達狀況對預測乳腺癌化療敏感性的臨床價值[J]. 中華臨床醫師雜志(電子版), 2010, 4(10): 1789-1793.
23.	Mieog JS, de VV. Neoadjuvant chemotherapy for early breast cancer[J]. Expert Opin Pharmacother, 2009, 10(9): 1423-1434.
24.	Bonadonna G. Evolving concepts in the systemic adjuvant treatment of breast cancer[J]. Cancer Res, 1992, 52(8): 2127-2137.
25.	Schott AF, Hayes DF. Defining the benefits of neoadjuvant chemotherapy for breast cancer[J]. J Clin Oncol, 2012, 30(15): 1747-1749.
26.	Takahashi T, Takahashi T, Suzuki H, et al. The p53 gene is very frequently mutated in small-cell lung cancer with a distinct nucleotide substitution pattern[J]. Oncogene, 1991, 6(10): 1775-1778.
27.	Alizadeh AA, Ross DT, Perou CM, et al. Towards a novel classification of human malignancies based on gene expression patterns[J]. J Pathol, 2001, 195(1): 41-52.
28.	Ellis PA, Smith IE, McCarthy K, et al. Preoperative chemotherapy induces apoptosis in early breast cancer[J]. Lancet, 1997, 349(9055): 849.

1. 　Connolly RM, Stearns V. Current approaches for neoadjuvant chemotherapy in breast cancer[J/OL]. Eur J Pharmacol, 2013[2013-04-28]. http://dx.doi.org/10.1016/j.ejphar.2013.02.057.
2. 　Charfare H, Limongelli S, Purushotham AD. Neoadjuvant chemotherapy in breast cancer[J]. Br J Surg, 2005, 92(1): 14-23.
3. 　Buchholz TA, Hunt KK, Whitman GJ, et al. Neoadjuvant chemotherapy for breast carcinoma: multidisciplinary considerations of benefits and risks[J]. Cancer, 2003, 98(6): 1150-1160.
4. 　Linjawi A, Kontogiannea M, Halwani F, et al. Prognostic significance of p53, bcl-2, and Bax expression in early breast cancer[J]. J Am Coll Surg, 2004, 198(1): 83-90.
5. 　Cecka F, Hornychova H, Melichar B, et al. Expression of bcl-2 in breast cancer: correlation with clinicopathological characteristics and survival[J]. Acta Medica (Hradec Kralove), 2008, 51(2): 107-112.
6. 　Yu B, Sun X, Shen HY, et al. Expression of the apoptosis-related genes BCL-2 and BAD in human breast carcinoma and their associated relationship with chemosensitivity[J]. J Exp Clin Cancer Res, 2010, 29: 107.
7. 　曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具[J]. 中國循證心血管醫學雜志, 2011, 8(4): 297-299.
8. 　趙迎春, 李勇, 朱永云, 等. ER、PR、p53和Bcl-2的表達變化在乳腺癌新輔助化療中的意義[J]. 現代腫瘤醫學, 2011, 19(10): 2017-2020.
9. 　阮永威, 金星, 馬宏巖, 等. 乳腺癌P53, ki-67和Bcl-2的表達與新輔助化療的關系[J]. 中國普通外科雜志, 2006, 15(4): 247-249.
10. 　徐勝前, 張春輝, 尤其俋. 乳腺癌新輔助化療Bcl-2和生存素的表達及其與化療反應的相關性[J]. 江蘇醫藥, 2007, 33(3): 236-238.
11. 　姜大慶, 趙林, 龍飛, 等. 乳腺癌新輔助化療中Ki-67、Bcl-2及AI的表達與化療效果關系的研究[J]. 中國實用外科雜志, 2005, 25(4): 230-231.
12. 　Tiezzi DG, De Andrade JM, Candido D, et al. Apoptosis induced by neoadjuvant chemotherapy in breast cancer[J]. Pathology, 2006, 38(1): 21-27.
13. 　Fernández-Sánchez M, Gamboa-Dominguez A, Uribe N, et al. Clinical and pathological predictors of the response to neoadjuvant anthracycline chemotherapy in locally advanced breast cancer[J]. Med Oncol, 2006, 23(2): 171-183.
14. 　劉瑞磊, 呂偉明, 衛洪波, 等.中華普通外科學文獻稿約[J/OL]. 中華普通外科學文獻·電子版, 2013, 2(2): 162-164.
15. 　凡慶東, 姜軍, 楊新華, 等. 乳腺癌p53、cerbB-2表達與TE方案新輔助化療療效的關系[J]. 重慶醫科大學學報, 2007, 32(10): 1059-1061.
16. 　林其聲, 施雄文, 徐書楷, 等. 新輔助化療對乳腺癌ki67、cox-2、p53表達的影響及其臨床意義[J]. 中國當代醫藥, 2009, 16(24): 13-14.
17. 　匡忠生, 謝宇暉, 何玉萍, 等. 乳腺癌新輔助化療療效與ER、PR、p53及HER2表達的關系[J]. 中國醫藥指南, 2012, 10(25): 401-403.
18. 　屈明, 趙建玲, 薛軍, 等. 乳腺癌腫瘤生物學因子檢測對新輔助化療方案選擇的指導作用[J]. 山東醫藥, 2009, 49(48): 59-61.
19. 　楊海松, 黃建軍, 毛大華, 等. 新輔助化療對乳腺癌雌激素受體和P53基因及人表皮生長因子受體-2的影響及意義[J]. 中國全科醫學, 2011, 14(12): 1292-1295.
20. 　王曉蘭, 陳波, 姚凡, 等. HER-2、p53的表達對乳腺癌蒽環類新輔助化療療效的影響[J]. 山東醫藥, 2008, 48(32): 1-3.
21. 　李艷萍, 張斌, 喻衛紅, 等. Bcl-2、C-erbB2和PCNA表達與乳腺癌新輔助治療療效關系的研究[J]. 中國腫瘤臨床與康復, 2007, 14(1): 8-10.
22. 　廖丹, 姚和瑞, 陳煥清. 表皮生長因子受體-2和P53及Ki67的表達狀況對預測乳腺癌化療敏感性的臨床價值[J]. 中華臨床醫師雜志(電子版), 2010, 4(10): 1789-1793.
23. 　Mieog JS, de VV. Neoadjuvant chemotherapy for early breast cancer[J]. Expert Opin Pharmacother, 2009, 10(9): 1423-1434.
24. 　Bonadonna G. Evolving concepts in the systemic adjuvant treatment of breast cancer[J]. Cancer Res, 1992, 52(8): 2127-2137.
25. 　Schott AF, Hayes DF. Defining the benefits of neoadjuvant chemotherapy for breast cancer[J]. J Clin Oncol, 2012, 30(15): 1747-1749.
26. 　Takahashi T, Takahashi T, Suzuki H, et al. The p53 gene is very frequently mutated in small-cell lung cancer with a distinct nucleotide substitution pattern[J]. Oncogene, 1991, 6(10): 1775-1778.
27. 　Alizadeh AA, Ross DT, Perou CM, et al. Towards a novel classification of human malignancies based on gene expression patterns[J]. J Pathol, 2001, 195(1): 41-52.
28. 　Ellis PA, Smith IE, McCarthy K, et al. Preoperative chemotherapy induces apoptosis in early breast cancer[J]. Lancet, 1997, 349(9055): 849.

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

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