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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。
Objective To evaluate the relationship between the expression of apoptosis-related genes bcl-2 and p53 and the efficacy of neoadjuvant chemotherapy (chemotherapy) in breast cancer. Methods A computer-based search of Cochrane, Pubmed, Embase, CNKI, Wanfang, Weipu and other databases, a case-control study of bcl-2, p53 protein and breast neoadjuvant chemotherapy from April 2003 to April 2013, using RevMan 4.2 statistics The software performs quantitative analysis. Results A total of 15 case-control studies were included. There were 6 cases of bcl-2 and neoadjuvant chemotherapy for breast cancer. 279 cases were effective, of which 159 cases were positive for bcl-2 expression; 115 cases were ineffective, of which 57 cases were positive for bcl-2 expression. There were 13 p53 and neoadjuvant chemotherapy for breast cancer, and 679 cases were effective, including 249 cases with positive p53 expression and 341 cases with treatment failure, of which 195 cases were positive for p53. Meta-analysis showed that the positive rate of bcl-2 expression and the efficacy of neoadjuvant chemotherapy for breast cancer were not statistically significant [OR=1.40, 95%CI (0.89, 2.18), P=0.14], while the positive rate of p53 expression was correlated with breast The efficacy of neoadjuvant chemotherapy for cancer was statistically significant [OR=0.46, 95% CI (0.26, 0.80), P=0.007]. Conclusion p53 can be used as an indicator of the sensitivity of neoadjuvant chemotherapy for breast cancer, suggesting a role for neoadjuvant chemotherapy in breast cancer.