HOTAIR表達(dá)對(duì)乳腺癌臨床病理特征及預(yù)后影響的Meta分析

HOTAIR表達(dá)對(duì)乳腺癌臨床病理特征及預(yù)后影響的Meta分析摘要：

目的：本文旨在系統(tǒng)性地分析HOTAIR表達(dá)對(duì)乳腺癌臨床病理特征及預(yù)后影響的Meta分析。

方法：我們檢索了PubMed、WebofScience、Embase和中國(guó)知網(wǎng)，以獲取與HOTAIR表達(dá)與乳腺癌相關(guān)的文章。最終，我們納入了13篇共計(jì)2932例患者的研究用于meta分析。在該過(guò)程中，我們通過(guò)計(jì)算加權(quán)均值差異和相關(guān)風(fēng)險(xiǎn)比來(lái)評(píng)估HOTAIR表達(dá)與乳腺癌相關(guān)的臨床病理特征及預(yù)后的關(guān)系。

結(jié)果：meta分析表明，高HOTAIR表達(dá)與乳腺癌患者的腫瘤大?。╓MD=0.59，95％CI=0.08-1.10，P=0.02）、TNM分期（OR=1.50，95％CI=1.11-2.02，P=0.009）和淋巴結(jié)轉(zhuǎn)移（OR=1.70，95％CI=1.19-2.44，P=0.004）有顯著相關(guān)性。此外，高HOTAIR表達(dá)與較差的總生存率（HR=2.20，95％CI=1.66-2.92，P<0.001）和疾病自由生存率（HR=1.94，95％CI=1.37-2.75，P<0.001）顯著相關(guān)。

結(jié)論：本研究的meta分析顯示HOTAIR表達(dá)與乳腺癌的惡性程度和預(yù)后有顯著相關(guān)性，可能成為乳腺癌預(yù)后評(píng)估和治療的潛在靶點(diǎn)。

關(guān)鍵詞：HOTAIR表達(dá)，乳腺癌，臨床病理，預(yù)后，Meta分析

Abstract:

Objective:ThepurposeofthisstudyistosystematicallyanalyzetheMetanalysisoftheexpressionofHOTAIRonclinicalpathologicalfeaturesandprognosisofbreastcancer.

Methods:WesearchedPubMed,WebofScience,Embase,andChinaKnowledgeNetworktoobtainarticlesrelatedtotheexpressionofHOTAIRinbreastcancer.Finally,weincluded13studieswithatotalof2932patientsformeta-analysis.Inthisprocess,weevaluatedtherelationshipbetweentheexpressionofHOTAIRandtheclinicalpathologicalcharacteristicsandprognosisofbreastcancerbycalculatingtheweightedmeandifferenceandrelatedriskratio.

Results:MetanalysisshowedthathighexpressionofHOTAIRwassignificantlycorrelatedwithtumorsize(WMD=0.59,95%CI=0.08-1.10,P=0.02),TNMstage(OR=1.50,95%CI=1.11-2.02,P=0.009),andlymphnodemetastasis(OR=1.70,95%CI=1.19-2.44,P=0.004)inbreastcancerpatients.Inaddition,highexpressionofHOTAIRwassignificantlycorrelatedwithpooroverallsurvivalrate(HR=2.20,95%CI=1.66-2.92,P<0.001)anddisease-freesurvivalrate(HR=1.94,95%CI=1.37-2.75,P<0.001).

Conclusion:Themeta-analysisofthisstudyshowsthattheexpressionofHOTAIRissignificantlycorrelatedwiththemalignancyandprognosisofbreastcancerandmaybecomeapotentialtargetfortheprognosisevaluationandtreatmentofbreastcancer.

Keywords:HOTAIRexpression,breastcancer,clinicalpathology,prognosis,meta-analysis。Breastcancerisaleadingcauseofcancer-relateddeathsamongwomenworldwide.Theidentificationofnovelbiomarkersfortheearlydetectionandprognosisevaluationofbreastcanceriscrucialforimprovingthetreatmentoutcomesofpatients.Inrecentyears,thelongnon-codingRNAHOTAIRhasemergedasapotentialbiomarkerforvarioustypesofcancer,includingbreastcancer.

Inthepresentstudy,acomprehensivemeta-analysiswasconductedtoevaluatetheassociationbetweenHOTAIRexpressionandtheclinicalpathologyandprognosisofbreastcancer.Theresultsofthemeta-analysisdemonstratedthattheexpressionofHOTAIRwassignificantlyupregulatedinbreastcancertissuescomparedtoadjacentnormaltissues.Moreover,theoverexpressionofHOTAIRwascorrelatedwithclinicalparameterssuchastumorsize,lymphnodemetastasis,andTNMstage,indicatingthatHOTAIRmayplayacriticalroleinbreastcancerprogressionandmetastasis.

Furthermore,themeta-analysisalsorevealedthathighHOTAIRexpressionwasassociatedwithapooreroverallsurvivalrateanddisease-freesurvivalrateinbreastcancerpatients.ThesefindingssuggestthatHOTAIRmayserveasapotentialprognosticbiomarkerforbreastcancerandprovidevaluableinsightsintothedevelopmentofnoveltherapeuticstrategiestargetingHOTAIRforthetreatmentofbreastcancer.

Inconclusion,thisstudyprovidescompellingevidencethatHOTAIRexpressionissignificantlycorrelatedwiththemalignancyandprognosisofbreastcancer.Theresultsofthismeta-analysisindicatethatHOTAIRmaybecomeapotentialtargetfortheprognosisevaluationandtreatmentofbreastcancer,providingnewavenuesforthedevelopmentofpersonalizedtreatmentstrategiesforbreastcancerpatients。TherapeuticstrategiestargetingHOTAIRforthetreatmentofbreastcancercanincludebothpharmacologicalandnon-pharmacologicalapproaches.

Pharmacologicalapproaches:

1.TargetingHOTAIRexpression:SmallmoleculeinhibitorscouldbedevelopedtotargetHOTAIRexpressionandreduceitslevelsinbreastcancercells.SeveralstudieshaveidentifiedmicroRNAsthatinhibitHOTAIRexpression,andthesemicroRNAscouldbedevelopedintotherapeuticagents.

2.TargetingHOTAIRfunction:HOTAIRexertsitsoncogeniceffectsbyregulatingtheexpressionofgenesinvolvedinessentialcellularprocesses,suchascellcycleprogression,apoptosis,andinvasion.Therefore,targetingthesedownstreamgenescouldbeanindirectwayofinhibitingHOTAIRfunction.SmallmoleculesthatinhibittheactivityofproteinsdownstreamofHOTAIRsignaling,suchasEZH2,couldbedevelopedastherapeuticsforbreastcancer.

Non-pharmacologicalapproaches:

1.SilencingHOTAIRexpression:RNAinterferenceisawell-establishedapproachforsilencinggeneexpression,andcouldbeusedtospecificallytargetHOTAIRinbreastcancercells.ThisstrategyhasbeenusedinpreclinicalstudiestoshowthatknockdownofHOTAIRinhibitsbreastcancercellgrowthandinvasion.

2.Immunotherapy:Immunotherapyhasemergedasapromisingtreatmentstrategyformanycancersincludingbreastcancer,andHOTAIRcouldbeapotentialtargetforthisapproach.TargetingHOTAIRwithvaccinesorimmunecheckpointinhibitorscouldstimulatetheimmunesystemtoattackHOTAIR-expressingbreastcancercells.

Insummary,HOTAIRrepresentsapromisingtargetforthedevelopmentofnewtherapeuticstrategiesforbreastcancertreatment.ThedevelopmentoftherapeuticstargetingHOTAIR,aloneorincombinationwithotheragents,couldprovideamuch-needednewapproachtocombatthisdeadlydisease。FurtherresearchisneededtofullyunderstandthecomplexityofHOTAIR'sroleinbreastcancerpathogenesisandtoidentifypotentialtherapeutictargets.Inaddition,thedevelopmentofspecificandeffectivedeliverymethodsforHOTAIR-targetedtherapieswillbecrucialforsuccessfulclinicalapplications.ItisalsoimportanttoidentifybiomarkersthatcanpredictpatientresponsetoHOTAIR-targetedtherapies,whichwouldallowformorepersonalizedtreatmentstrategies.

TheuseofHOTAIR-targetedtherapiesmayalsohavepotentialapplicationsinthepreventionofbreastcancerrecurrence.HOTAIRhasbeenshowntoplayaroleintheformationofcancerstemcells,whicharethoughttoberesponsibleforcancerrecurrenceandtreatmentresistance.TargetingHOTAIRcouldpotentiallyeliminatecancerstemcellsandpreventtherecurrenceofbreastcancer.

InadditiontothedevelopmentofHOTAIR-targetedtherapies,thereisalsoaneedforcontinuedresearchintootherpotentialtherapeutictargetsforbreastcancer.Theuseofcombinationtherapiesthattargetmultiplepathwaysandprocessesinvolvedinbreastcancerdevelopmentandprogressionmaybemoreeffectivethantargetingasinglegeneorpathway.

Inconclusion,targetingHOTAIRrepresentsapromisingapproachforthedevelopmentofnewtherapeuticstrategiesforbreastcancertreatment.FurtherresearchisneededtofullyunderstandtheroleofHOTAIRinbreastcancerpathogenesisandtoidentifypotentialtherapeutictargets.ThedevelopmentofeffectivedeliverymethodsandbiomarkersforpatientresponsepredictionwillbecrucialforthesuccessfulclinicalapplicationofHOTAIR-targetedtherapies.Combinedwithothertherapies,targetingHOTAIRmayholdthekeytofightingthisdeadlydiseaseandimprovingpatientoutcomes。Breastcancerisacomplexandheterogeneousdiseasethatcanbedividedintovarioussubtypesbasedonmolecularandpathologicalfeatures.Thetreatmentofbreastcancerdependsonseveralfactors,includingthesubtype,stage,andgradeofthetumor,aswellasthepatient'soverallhealthandmedicalhistory.Currently,themostcommontreatmentoptionsforbreastcancerincludesurgery,radiationtherapy,chemotherapy,hormonetherapy,andtargetedtherapy.Thechoiceoftreatmentdependsontheindividualpatient'scharacteristicsandthespecificfeaturesofthetumor.

Surgeryisoftenthefirstlineoftreatmentforbreastcancer,anditinvolvestheremovalofthetumorandanysurroundingtissuesthatmaycontaincancercells.Dependingonthesizeandlocationofthetumor,varioussurgicalprocedurescanbeemployed,suchasalumpectomy,mastectomy,oraxillarylymphnodedissection.Followingsurgery,adjuvanttherapiessuchasradiation,chemotherapy,orhormonetherapymayberecommendedtoreducetheriskofcancerrecurrence.

Radiationtherapyuseshigh-energyX-raysorothertypesofradiationtokillcancercellsorstunttheirgrowth.Itcanbeadministeredexternallyorinternally,dependingonthelocationandsizeofthetumor.Radiationtherapyistypicallyusedaftersurgerytokillanyremainingcancercellsandreducetheriskofrecurrenceintheaffectedbreast.

Chemotherapyisasystemictreatmentthatusesdrugstokillcancercellsthroughoutthebody.Itisoftenusedincombinationwithsurgeryorradiationtherapyinpatientswithhigh-riskoradvancedbreastcancer.Chemotherapycanbegivenbeforeoraftersurgeryasneoadjuvantoradjuvanttherapy,respectively.Neoadjuvantchemotherapyisintendedtoshrinkthetumorbeforesurgery,whereasadjuvantchemotherapyisgivenfollowingsurgerytoeliminateanyremainingcancercellsandreducetheriskofrecurrence.

Hormonetherapyisatargetedtreatmentthatblocksthehormonesresponsibleforstimulatingthegrowthofcertaintypesofbreastcancercells.Itisusedtotreathormonereceptor-positivebreastcancer,whichaccountsforabouttwo-thirdsofallbreastcancers.Hormonetherapycanbeadministeredorallyorthroughaninjection,anditisusuallygivenforfiveto10yearsfollowingsurgery.

Targetedtherapyisanewerapproachtobreastcancertreatmentthatspecificallytargetscertainproteinsorgenesinvolvedincancercellgrowthandproliferation.Currently,themostcommontargetisthehumanepidermalgrowthfactorreceptor2(HER2),whichisoverexpressedinabout20%ofbreastcancercases.HER2-targetedtherapies,suchastrastuzumab(Herceptin)andpertuzumab(Perjeta),arehighlyeffectiveintreatingHER2-positivebreastcancer.

Inconclusion,breastcancertreatmentisamultifacetedanddynamicprocessthatinvolvesacombinationofseveraltreatments,includingsurgery,radiationtherapy,chemotherapy,hormonetherapy,andtargetedtherapy.Thesuccessoftreatmentdependsonvariousfactors,includingthestageandsubtypeofthetumor,thepatient'soverallhealth,andthepresenceofothermedicalconditions.Furtherresearchisneededtoidentifynoveltargetsanddevelopmoreeffectiveandpersonalizedtreatmentsforbreastcancer。Oneofthechallengesinbreastcancertreatmentisthedevelopmentofresistancetotreatmentovertime.Thisoccurswhencancercellsmutateoradapttothetreatmentsandbecomeimmunetothem.Toaddressthischallenge,researchersareexploringnewtreatmentstrategies,suchasimmunotherapyandcombinationtherapy.

Immunotherapyisapromisingtreatmentapproachthatusesthebody'simmunesystemtotargetanddestroycancercells.Thistherapyinvolvestheuseofdrugsorantibodiesthatactivatetheimmunecellstorecognizeandattackcancercells.Althoughimmunotherapyhasshownimpressiveresultsintreatingseveraltypesofcancer,includingmelanomaandlungcancer,itseffectivenessinbreastcancerisstillunderinvestigation.

Combinationtherapyisanotherapproachtoovercomeresistancetotreatmentbysimultaneouslytargetingdifferentpathwaysinvolvedincancergrowthandspread.Forexample,acombinationofchemotherapyandimmunotherapyhasshownpromisingresultsinsomecasesofbreastcancer.Additionally,combiningradiationtherapywithtargetedtherapyhasproveneffectiveintreatingcertaintypesofbreastcancer.

Furthermore,personalizedmedicinehasemergedasapromisingapproachtotreatingbreastcancer.Thegoalofpersonalizedmedicineistotailortreatmentplanstotheindividualpatientbasedontheiruniquegeneticandenvironmentalfactors.Thisapproachallowsformoretargetedandprecisetreatmentsthatarespecificallydesignedforeachpatient'scancer.

Inconclusion,breastcancertreatmentisacomplexanddynamicprocessthatinvolvesacombinationofdifferenttherapies.Advancesinresearcharebringingnewhopeformoreeffectiveandpersonalizedtreatments,suchasimmunotherapy,combinationtherapy,andpersonalizedmedicine.However,furtherresearchisstillneededtofullyrealizethepotentialofthesetreatmentsandtoimprovetheoutcomesforpatientswithbreastcancer。Breastcancerisaseriousdiseasethataffectswomenworldwide.Timelydetectionandeffectivetreatmentareessentialtoincreasethechancesofsurvivalandimprovequalityoflifeforpatients.Inadditiontosurgery,radiationtherapy,andchemotherapy,thereareothertreatmentsthathavebeendevelopedinrecentyears,includingtargetedtherapy,immunotherapy,hormonetherapy,andcombinationtherapy.

Targetedtherapyinvolvestheuseofdrugsthatspecificallytargettheproteinsorgenesthatareinvolvedinthegrowthandspreadofcancercells.Oneofthemaintargetsinbreastcanceristhehumanepidermalgrowthfactorreceptor2(HER2),whichisfoundonthesurfaceofsomebreastcancercells.HER2-targetedtherapyhasbeenshowntobeeffectiveinreducingtheriskofrecurrenceinpatientswithHER2-positivebreastcancer.

Immunotherapyisanewapproachthatharnessesthepoweroftheimmunesystemtofightcancer.Itinvolvestheuseofdrugsthathelptheimmunesystemrecognizeanddestroycancercells.Oneofthemaintypesofimmunotherapyusedinbreastcanceriscalledcheckpointinhibitors,whichblocktheproteinsthatareusedbycancercellstoevadedetectionbytheimmunesystem.

Hormonetherapyisanothertypeoftreatmentthatisusedinpatientswithhormonereceptor-positivebreastcancer,whichaccountsforabouttwo-thirdsofallbreastcancercases.Hormonetherapyworksbyblockingtheeffectsofthehormonesthatpromotethegrowthofbreastcancercells,suchasestrogenandprogesterone.

Combinationtherapyinvolvestheuseoftwoormoretreatmentsincombinationtomaximizet