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; 新辅助化疗; Meta分析

DOI：

10.7507/1002-0179.20130529

Video：

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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。

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.	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2011, 8(4): 297-299.
8.	赵迎春, 李勇, 朱永云, 等. ER、PR、p53和Bcl-2的表达变化在乳腺癌新辅助化疗中的意义[J]. 现代肿瘤医学, 2011, 19(10): 2017-2020.
9.	阮永威, 金星, 马宏岩, 等. 乳腺癌P53, ki-67和Bcl-2的表达与新辅助化疗的关系[J]. 中国普通外科杂志, 2006, 15(4): 247-249.
10.	徐胜前, 张春辉, 尤其俋. 乳腺癌新辅助化疗Bcl-2和生存素的表达及其与化疗反应的相关性[J]. 江苏医药, 2007, 33(3): 236-238.
11.	姜大庆, 赵林, 龙飞, 等. 乳腺癌新辅助化疗中Ki-67、Bcl-2及AI的表达与化疗效果关系的研究[J]. 中国实用外科杂志, 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.	刘瑞磊, 吕伟明, 卫洪波, 等.中华普通外科学文献稿约[J/OL]. 中华普通外科学文献·电子版, 2013, 2(2): 162-164.
15.	凡庆东, 姜军, 杨新华, 等. 乳腺癌p53、cerbB-2表达与TE方案新辅助化疗疗效的关系[J]. 重庆医科大学学报, 2007, 32(10): 1059-1061.
16.	林其声, 施雄文, 徐书楷, 等. 新辅助化疗对乳腺癌ki67、cox-2、p53表达的影响及其临床意义[J]. 中国当代医药, 2009, 16(24): 13-14.
17.	匡忠生, 谢宇晖, 何玉萍, 等. 乳腺癌新辅助化疗疗效与ER、PR、p53及HER2表达的关系[J]. 中国医药指南, 2012, 10(25): 401-403.
18.	屈明, 赵建玲, 薛军, 等. 乳腺癌肿瘤生物学因子检测对新辅助化疗方案选择的指导作用[J]. 山东医药, 2009, 49(48): 59-61.
19.	杨海松, 黄建军, 毛大华, 等. 新辅助化疗对乳腺癌雌激素受体和P53基因及人表皮生长因子受体-2的影响及意义[J]. 中国全科医学, 2011, 14(12): 1292-1295.
20.	王晓兰, 陈波, 姚凡, 等. HER-2、p53的表达对乳腺癌蒽环类新辅助化疗疗效的影响[J]. 山东医药, 2008, 48(32): 1-3.
21.	李艳萍, 张斌, 喻卫红, 等. Bcl-2、C-erbB2和PCNA表达与乳腺癌新辅助治疗疗效关系的研究[J]. 中国肿瘤临床与康复, 2007, 14(1): 8-10.
22.	廖丹, 姚和瑞, 陈焕清. 表皮生长因子受体-2和P53及Ki67的表达状况对预测乳腺癌化疗敏感性的临床价值[J]. 中华临床医师杂志(电子版), 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. 　曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2011, 8(4): 297-299.
8. 　赵迎春, 李勇, 朱永云, 等. ER、PR、p53和Bcl-2的表达变化在乳腺癌新辅助化疗中的意义[J]. 现代肿瘤医学, 2011, 19(10): 2017-2020.
9. 　阮永威, 金星, 马宏岩, 等. 乳腺癌P53, ki-67和Bcl-2的表达与新辅助化疗的关系[J]. 中国普通外科杂志, 2006, 15(4): 247-249.
10. 　徐胜前, 张春辉, 尤其俋. 乳腺癌新辅助化疗Bcl-2和生存素的表达及其与化疗反应的相关性[J]. 江苏医药, 2007, 33(3): 236-238.
11. 　姜大庆, 赵林, 龙飞, 等. 乳腺癌新辅助化疗中Ki-67、Bcl-2及AI的表达与化疗效果关系的研究[J]. 中国实用外科杂志, 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. 　刘瑞磊, 吕伟明, 卫洪波, 等.中华普通外科学文献稿约[J/OL]. 中华普通外科学文献·电子版, 2013, 2(2): 162-164.
15. 　凡庆东, 姜军, 杨新华, 等. 乳腺癌p53、cerbB-2表达与TE方案新辅助化疗疗效的关系[J]. 重庆医科大学学报, 2007, 32(10): 1059-1061.
16. 　林其声, 施雄文, 徐书楷, 等. 新辅助化疗对乳腺癌ki67、cox-2、p53表达的影响及其临床意义[J]. 中国当代医药, 2009, 16(24): 13-14.
17. 　匡忠生, 谢宇晖, 何玉萍, 等. 乳腺癌新辅助化疗疗效与ER、PR、p53及HER2表达的关系[J]. 中国医药指南, 2012, 10(25): 401-403.
18. 　屈明, 赵建玲, 薛军, 等. 乳腺癌肿瘤生物学因子检测对新辅助化疗方案选择的指导作用[J]. 山东医药, 2009, 49(48): 59-61.
19. 　杨海松, 黄建军, 毛大华, 等. 新辅助化疗对乳腺癌雌激素受体和P53基因及人表皮生长因子受体-2的影响及意义[J]. 中国全科医学, 2011, 14(12): 1292-1295.
20. 　王晓兰, 陈波, 姚凡, 等. HER-2、p53的表达对乳腺癌蒽环类新辅助化疗疗效的影响[J]. 山东医药, 2008, 48(32): 1-3.
21. 　李艳萍, 张斌, 喻卫红, 等. Bcl-2、C-erbB2和PCNA表达与乳腺癌新辅助治疗疗效关系的研究[J]. 中国肿瘤临床与康复, 2007, 14(1): 8-10.
22. 　廖丹, 姚和瑞, 陈焕清. 表皮生长因子受体-2和P53及Ki67的表达状况对预测乳腺癌化疗敏感性的临床价值[J]. 中华临床医师杂志(电子版), 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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