背景:N-myc下游调节基因1(NDRG1)被描述为一种有效的转移抑制因子,但它在人类乳腺癌中的作用仍存在争议和不清楚。因此,本研究利用系统综述和荟萃分析方法综合了NDRG1蛋白表达与乳腺癌侵袭性特征之间的关联.
方法:系统评价和荟萃分析的方案在PROSPERO网站(CRD42023414814)上注册。在PubMed中搜索了相关文章,Scopus,Embase,MEDLINE,和奥维德在2023年3月30日至2023年5月5日之间。使用JoannaBriggs研究所关键评估工具对纳入的研究进行了严格评估。个别研究的结果使用文本叙事综合进行定性综合。使用随机效应模型,效果估计的汇总对数比值比用于观察NDRG1蛋白表达与乳腺癌侵袭性特征之间的联系,如肿瘤分级,肿瘤分期,转移到腋窝淋巴结,和激素受体状态。
结果:从电子数据库搜索中检索到1423篇文章,并纳入了符合资格标准的6项研究进行综合.NDRG1蛋白的表达与腋窝淋巴结状态之间存在关联(P=0.01,对数赔率比(OR):0.59,95%置信区间(CI):0.13-1.05,I2:24.24%,腋窝淋巴结阳性乳腺癌292例,腋窝淋巴结阴性乳腺癌229例,4项研究)。NDRG1蛋白表达与人表皮生长因子受体2(Her2)状态呈负相关(P=0.01,logOR:-0.76,95%CI:-1.32-(-0.20),I2:32.42%,197例Her2阳性的乳腺癌和272例Her2阴性的乳腺癌。3项研究)。NDRG1蛋白表达与肿瘤分级无相关性(P=0.10)。雌激素受体(ER)状态(P=0.57),或孕激素受体(PR)状态(P=0.41)。
结论:该研究得出结论,NDRG1蛋白表达增加与肿瘤向腋窝淋巴结转移增加有关。此外,在Her2阴性乳腺癌中观察到NDRG1蛋白表达增加,根据乳腺癌亚型的不同,表明其在不那么积极和更积极的行为中的作用。根据荟萃分析的结果,NDRG1蛋白表达增加与乳腺癌侵袭性特征相关.
BACKGROUND: N-myc downstream-regulated gene-1 (NDRG1) is well-described as a potent metastasis suppressor, but its role in human breast cancer remains controversial and unclear. Therefore, the present study utilized a systematic
review and meta-analysis approach to synthesize the association between NDRG1 protein expression and the aggressive characteristics of breast cancer.
METHODS: The protocol for the systematic
review and meta-analysis was registered on the PROSPERO website (CRD42023414814). Relevant articles were searched for in PubMed, Scopus, Embase, MEDLINE, and Ovid between March 30, 2023, and May 5, 2023. The included studies were critically evaluated using the Joanna Briggs Institute critical appraisal tools. The results from individual studies were qualitatively synthesized using textual narrative synthesis. Using a random-effects model, the pooled log odds ratio of effect estimate was used to look at the link between NDRG1 protein expression and aggressive features of breast cancer, such as tumor grade, tumor stage, metastasis to the axillary lymph nodes, and hormonal receptor status.
RESULTS: A total of 1423 articles were retrieved from the electronic database search, and six studies that met the eligibility criteria were included for synthesis. There was an association between the expression of NDRG1 protein and the status of the axillary lymph nodes (P = 0.01, log Odds Ratio (OR): 0.59, 95% Confidence Interval (CI): 0.13-1.05, I2: 24.24%, 292 breast cancer cases with positive axillary lymph nodes and 229 breast cancer cases with negative axillary lymph nodes, 4 studies). NDRG1 protein expression and human epidermal growth factor receptor 2 (Her2) status were found to have a negative relationship (P = 0.01, log OR: -0.76, 95% CI: -1.32-(-0.20), I2: 32.42%, 197 breast cancer cases with Her2 positive and 272 breast cancer cases with Her2 negative, 3 studies). No correlation was found between NDRG1 protein expression and tumor grade (P = 0.10), estrogen receptor (ER) status (P = 0.57), or progesterone receptor (PR) status (P = 0.41).
CONCLUSIONS: The study concluded that increased NDRG1 protein expression was associated with increased metastasis of the tumor to the axillary lymph node. Additionally, increased NDRG1 protein expression was observed in Her2-negative breast cancer, suggesting its role in both less aggressive and more aggressive behavior depending on breast cancer subtypes. Based on the findings of the meta-analysis, an increase in NDRG1 protein expression was associated with aggressive characteristics of breast cancer.