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Meta-Analysis
. 2017 Sep;96(36):e8000.
doi: 10.1097/MD.0000000000008000.

The prognostic value and potential drug target of phosphatase and tensin homolog in breast cancer patients: A meta-analysis

Feng Xu  1 , Chao Zhang, Jianxiu Cui, Jun Liu, Jie Li, Hongchuan Jiang
Affiliations
Meta-Analysis

The prognostic value and potential drug target of phosphatase and tensin homolog in breast cancer patients: A meta-analysis

Feng Xu et al. Medicine (Baltimore). 2017 Sep.

Abstract

Background: The prognostic significance of phosphatase and tensin homolog (PTEN) in patients with breast cancer (BC) remains controversial. The aims of our meta-analysis are to evaluate its association with clinicopathological characteristics and prognostic value in patients with breast cancer.

Methods: PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI) were systematically searched up to December 2016. The meta-analysis was performed using hazard ratio (HR), odds ratio (OR), and 95% confidence intervals (CI) as effect measures. A fixed or random effect model was used depending on the heterogeneity analysis. Statistical analysis was performed using Review manager software version 5.3.

Results: Seventeen studies including 4343 patients with breast cancer were analyzed. The meta-analysis indicated that breast cancers with PTEN loss were significantly associated with the tumor size ≥2 cm group (ORFEM = 1.68, 95%CIFEM [1.34, 2.10]), negative expression of estrogen receptor (ORREM = 1.95, 95%CIREM [1.09, 3.49]), negative expression of progesterone receptor (ORFEM = 1.72, 95%CIFEM [1.43, 2.08]), the advanced stage (ORREM = 1.94, 95%CIREM [1.35, 2.80]), positive axillary lymph node metastasis (ORREM = 1.80, 95%CIREM [1.30, 2.50]), and the local recurrence (ORFEM = 1.70, 95%CIFEM [1.26, 2.28]). None of other clinicopathological parameters such as the HER2 status and distant metastasis were associated with PTEN loss. The decreased PTEN expression was significantly correlated with the overall survival (OS) of patients (HRREM = 1.83, 95%CIREM [1.32, 2.53]) and the disease-free survival (DFS) of patients (HRREM = 2.43, 95%CIREM [1.31, 4.53]).

Conclusion: Our meta-analysis demonstrates that PTEN loss is of particular importance for predicting breast cancer aggressiveness and poor prognosis. PTEN is a potential drug target for the development of individualized treatment in BC patients.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
PRISMA flow chart of the literature search.
Figure 2
Figure 2
Forest plots of studies evaluating hazard ratios (HRs) of PTEN for overall survival (A) and disease-free survival (B) with the random effect model. HRs = hazard ratios, PTEN = phosphatase and tensin homolog.
Figure 3
Figure 3
Forest plots of studies evaluating the association between PTEN and clinical parameters in breast cancer. (A) Tumor size (≥2 cm vs <2 cm), (B) ER status (negative vs positive), (C) PR status (negative vs positive), (D) HER-2 status (positive vs negative), (E) lymph node metastasis (present vs absent), (F) tumor stage (III+IV vs I+II), (G) local recurrence (present vs absent), (H) distant metastasis (present vs absent). ER = estrogen progesterone receptor, HER-2 = human epidermal growth factor 2 receptor, PR = progesterone receptor, PTEN = phosphatase and tensin homolog.
Figure 4
Figure 4
Funnel plots for all the included studies reported with OS (A) and DFS. (B). OS = overall survival, DFS = disease-free survival.
See this image and copyright information in PMC

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