| Objective:Breast cancer is now the most common cause of cancer-related deaths among women worldwide.Triple-negative breast cancer(TNBC)has poor prognosis and lack of treatment methods because of its unknown pathogenesis driver gene’s and lack of clear therapeutic targets.Recent studies have shown that androgen receptor(AR)expression in patients with androgen receptor-positive breast cancer may cross-interact with several important signaling pathways,including key molecules and receptors,affecting the prognosis of TNBC patients,it is expected to become a new therapeutic target for TNBC.Therefore,by reviewing the clinical research and data at home and abroad,we summarized on the prognosis and clinical pathological characteristics data of AR expression in patients with TNBC,in the form of meta-analysis,system evaluation of AR expression with TNBC prognosis and the correlation between clinical features,objective evaluation AR role relationship,in order to guide the clinical decision,individualized treatment precision can be improved.Methods:To identify the major studies for this purpose,we searched domestic and foreign databases,including the relevant literatures on the prognosis and clinicopathological characteristics of AR and TNBC.The databases include PubMed,Embase,the Cochrane Library,Web of science,Med-line,CNKI,Wan-fang database,the retrieval time is from the self-established database to December 2020.Outcome indicators included overall survival(OS),disease-free survival(DFS),axillary lymph node metastasis,high Ki-67 expression(Ki-67≥14),tumor size(>2cm),high histological grade(Grade Ⅲ)and other clinical pathological characteristics.The original literature was rigorously evaluated according to the Newcastle-Ottawa scale(NOS)designed for cohort studies and case-control studies.The Stata15.1 software was used for the combination and meta-analysis of outcome indicators.Based on the heterogeneity of the included studies,effect sizes were combined using fixed effect or random effect models,respectively.For studies with high heterogeneity,variable heterogeneity and impact were further evaluated through subgroup analysis and sensitivity analysis.Results:A total of 28 studies were included in the meta-analysis with 4912 patients in TNBC,all of which were cohort studies with NOS scores≥6,and could be considered to be of high quality.Meta-analysis results showed that AR expression was not associated with OS and DFS in TNBC(OS:HR=0.99,95%CI:0.95,0.04,P=0.661>0.05;DFS:HR=1.00,95%C I:0.96-1.03,P=0.800>0.05).Due to the high heterogeneity between OS and DFS groups,sub group analysis was conducted according to the possible sources of he terogeneity.In the subgroup analysis of AR cut-off value,there was no correlation between AR expression and OS and DFS of TNBC pa tients in either the high-cut-off value group(10%)or the low-cut-off v alue group(0%,1%,5%,7.5%)analysis(high-cut-off value group:OS:HR=1.10,95%CI:0.78-1.55,P=0.594,DFS:HR=0.98,95%CI:0.73-1.32,P=0.917,1 ow-cut-off value group:OS:HR=0.80,95%CI:0.5 2-1.23,P=0.315 DFS:HR=0.80,95%CI:0.55-1.16,P=0.236).Among other AR cutoff values,AR expression is not significantly correlated with OS,but is correlated w ith DFS(OS:HR=0.46,95%CI:0.10-2.08,P=0.314,DFS:HR=1.95,95%CI:1.07-3.55,P=0.029).According to different study regions,different analy sis methods and different AR antibody subgroup analysis,there was no statistically significant difference in prognosis.In clinicopathological analysis,AR(-)was more prone to axillar y lymph node metastasis than AR(+),and was correlated with high histological grade(grade Ⅲ),the difference was statistically significan t(RR=0.81,95%CI:0.72-0.91,P=0.001<0.05;RR=0.82,95%CI:0.77-0.86,P=0.0001<0.05).There was no significant correlation between AR expr ession and Ki-67 or tumor size(RR=0.93,95%CI:0.84-1.03,P=0.158>0.05,RR=0.96,95%CI:0.91-1.02,P=0.199>0.05).Conclusion:In TNBC patients,regardless of whether there are confounding factors,there is no significant correlation between AR expression and patients’ OS and DFS.In the analysis of clinicopathological characteristics,AR expression is correlated with axillary lymph node metastasis and high-grade histological grade,but has nothing to do with Ki-67 expression and tumor size. |
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