| Objective: Understanding the expression of CK5/6, AR in triple negative breast carcinoma by using Meta-analysis, estimating relation between them and prognosis, and providing the basis for clinical treatment of triple negative breast carcinoma.Methods: Putting “CK5/6”, “cytokeratin 5/6”, “AR”, “androgen receptor”, “triple neg ative breast cancer”, “triple neg at ive breast carcinoma” and “TNBC” as keywords,we systematically searched Pubmed, Cochrane Library, Web of science, CNKI, Wangfang, VIP databases to identify the publication of clinical studies on the correlation between CK5/6, AR expression and prognosis and prediction of triple negative breast cancer, from inception to Nvember, 2015. After screening, we removed duplicate articles by applying endnote software and by hand, two researchers subsequently screened articles in the light of inclusion and exclusion criterias, evaluated the quality of the studies and extracting data. Recruited studies were examined by meta-analysis of Rev Man5.3 software. Funnel polts were used for evaluating publication bias, The sensitivity analysis were applied to estimate stability of studies.Result: 23 studies with 4258 TNBC and NTNBC patients, involving relevance of CK5/6 and TNBC, had were recruited. Meta analysis showed that significant difference of CK5/6 positive expression was existed between TNBC and NTNBC(OR = 17.07, 95 % CI :11.17 ~ 26.08, P < 0.05); Significant difference was showed in lymph nodes metastasis( OR = 3.35, 95 % CI:1.08 ~ 10.40, P < 0.05); Menopausal status( OR = 1.05, 95 % CI : 0.41 ~ 2.64, P = 0.92), tumor size( OR = 0.72, 95 % CI :0.42 ~ 1.23,P=0.23), tumor staging( OR = 0.71, 95 % CI : 0.32 ~ 1.57, P = 0.40)and histological grade(OR = 0.71, 95 % CI : 0.22 ~ 2.32,P = 0.57)were not existed significant differences, respectively; In terms of survival time, there were significant differences in disease-free survival( OR = 1.94, 95 % CI:1.17 ~ 3.22, P < 0.05) and oveall survival(OR = 1.48, 95 % CI : 1.22 ~ 1.78, P < 0.05)between CK5/6 positive groups and negative groups. Funnel polts were fundamentally symmetric, and results of studies were stable.13 studies with 2823 TNBC, involving relation of AR and TNBC, had were acquired. AR expression was significantly related with menopausal stuta(OR = 2.13, 95 % CI : 1.51 ~ 2.99, P < 0.05) and histoligical grade(OR =3.16, 95 % CI : 2.03 ~ 4.91, P < 0.05). No clear correlation were displayed between AR expression and tumor size( OR = 0.94, 95 % CI : 0.74 ~ 1.20, P = 0.63), clinical stage(OR = 1.34, 95 % CI : 0.64 ~ 2.80, P = 0.43), lymph nodes metastasis(OR = 0.75, 95 % CI : 0.46 ~ 1.22, P = 0.24), lymphocytic invasion(OR = 0.99, 95 % CI : 0.78 ~ 1.27, P = 0.97), tumor nectosis(OR = 0.47, 95 % CI : 0.11 ~ 2.06, P = 0.32). In the aspect of survival time, Meta-analysis revealed that AR expression were related to poor disease-free survival(OR = 1.96, 95 % CI : 1.24 ~ 3.10, P < 0.05) and poor overall survival(OR = 3.08, 95 % CI : 1.60 ~ 5.91, P < 0.05). Funnel polts were fundamentally symmetric, and results of studies were stable.Conclusions: The expression of CK5/6、AR has positive correlation on lymph node metastasis and survival of triple negative breast cancer,and the expression of AR shows negative relationship with histoligical grade and survival of triple negative breast cancer. Detecting CK5/6、AR expression will help us to judge clinical features and survival of triple negative breast cancer and provide theoretical guidance for clinical treastment and prognosis judgement. |
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