Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis
Background: High cathepsin D has been associated with poor prognosis in breast cancer; however, the results of many studies are controversial. Here, we assessed the association between high cathepsin D levels and worse breast cancer prognosis by conducting a meta-analysis. Methods: A comprehensive s...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-06-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/1758835920927838 |
| _version_ | 1828960920407113728 |
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| author | Junho Kang Yeuni Yu Seongdo Jeong Hansong Lee Hye Jin Heo Jeong Jun Park Hee Sam Na Dai Sik Ko Yun Hak Kim |
| author_facet | Junho Kang Yeuni Yu Seongdo Jeong Hansong Lee Hye Jin Heo Jeong Jun Park Hee Sam Na Dai Sik Ko Yun Hak Kim |
| author_sort | Junho Kang |
| collection | DOAJ |
| description | Background: High cathepsin D has been associated with poor prognosis in breast cancer; however, the results of many studies are controversial. Here, we assessed the association between high cathepsin D levels and worse breast cancer prognosis by conducting a meta-analysis. Methods: A comprehensive search strategy was used to search relevant literature in PUBMED and EMBASE by September 2018. The meta-analysis was performed in Review Manager 5.3 using hazard ratios (HRs) with 95% confidence intervals (CIs). Results: A total of 15,355 breast cancer patients from 26 eligible studies were included in this meta-analysis. Significant associations between elevated high cathepsin D and poor overall survival (OS) (HR = 1.61, 95% CI: 1.35–1.92, p < 0.0001) and disease-free survival (DFS) (HR = 1.52, 95% CI: 1.31–2.18, p < 0.001) were observed. In the subgroup analysis for DFS, high cathepsin D was significantly associated with poor prognosis in node-positive patients (HR = 1.38, 95% CI: 1.25–1.71, p < 0.00001), node-negative patients (HR = 1.78, 95% CI: 1.39–2.27, p < 0.0001), early stage patients (HR = 1.73, 95% CI: 1.34–2.23, p < 0.0001), and treated with chemotherapy patients (HR = 1.60, 95% CI: 1.21–2.12, p < 0.001). Interestingly, patients treated with tamoxifen had a low risk of relapse when their cathepsin D levels were high (HR = 0.71, 95% CI: 0.52–0.98, p = 0.04) and a high risk of relapse when their cathepsin D levels were low (HR = 1.50, 95% CI: 1.22–1.85, p = 0.0001). Conclusions: Our meta-analysis suggests that high expression levels of cathepsin D are associated with a poor prognosis in breast cancer. Based on our subgroup analysis, we believe that cathepsin D can act as a marker for poor breast cancer prognosis and also as a therapeutic target for breast cancer. |
| first_indexed | 2024-12-14T09:36:07Z |
| format | Article |
| id | doaj.art-b2bd60b3de924f6db83ab134a2ecd7e8 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-12-14T09:36:07Z |
| publishDate | 2020-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-b2bd60b3de924f6db83ab134a2ecd7e82022-12-21T23:07:55ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592020-06-011210.1177/1758835920927838Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysisJunho KangYeuni YuSeongdo JeongHansong LeeHye Jin HeoJeong Jun ParkHee Sam NaDai Sik KoYun Hak KimBackground: High cathepsin D has been associated with poor prognosis in breast cancer; however, the results of many studies are controversial. Here, we assessed the association between high cathepsin D levels and worse breast cancer prognosis by conducting a meta-analysis. Methods: A comprehensive search strategy was used to search relevant literature in PUBMED and EMBASE by September 2018. The meta-analysis was performed in Review Manager 5.3 using hazard ratios (HRs) with 95% confidence intervals (CIs). Results: A total of 15,355 breast cancer patients from 26 eligible studies were included in this meta-analysis. Significant associations between elevated high cathepsin D and poor overall survival (OS) (HR = 1.61, 95% CI: 1.35–1.92, p < 0.0001) and disease-free survival (DFS) (HR = 1.52, 95% CI: 1.31–2.18, p < 0.001) were observed. In the subgroup analysis for DFS, high cathepsin D was significantly associated with poor prognosis in node-positive patients (HR = 1.38, 95% CI: 1.25–1.71, p < 0.00001), node-negative patients (HR = 1.78, 95% CI: 1.39–2.27, p < 0.0001), early stage patients (HR = 1.73, 95% CI: 1.34–2.23, p < 0.0001), and treated with chemotherapy patients (HR = 1.60, 95% CI: 1.21–2.12, p < 0.001). Interestingly, patients treated with tamoxifen had a low risk of relapse when their cathepsin D levels were high (HR = 0.71, 95% CI: 0.52–0.98, p = 0.04) and a high risk of relapse when their cathepsin D levels were low (HR = 1.50, 95% CI: 1.22–1.85, p = 0.0001). Conclusions: Our meta-analysis suggests that high expression levels of cathepsin D are associated with a poor prognosis in breast cancer. Based on our subgroup analysis, we believe that cathepsin D can act as a marker for poor breast cancer prognosis and also as a therapeutic target for breast cancer.https://doi.org/10.1177/1758835920927838 |
| spellingShingle | Junho Kang Yeuni Yu Seongdo Jeong Hansong Lee Hye Jin Heo Jeong Jun Park Hee Sam Na Dai Sik Ko Yun Hak Kim Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis Therapeutic Advances in Medical Oncology |
| title | Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis |
| title_full | Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis |
| title_fullStr | Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis |
| title_short | Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis |
| title_sort | prognostic role of high cathepsin d expression in breast cancer a systematic review and meta analysis |
| url | https://doi.org/10.1177/1758835920927838 |
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