{"title":"较短的端粒长度作为乳腺癌生存和复发的预后标志物:一项系统回顾和荟萃分析。","authors":"Dhyas Munandar Arya Sasmita, Kavi Gilang Permana, Teguh Aryandono, Didik Setyo Heriyanto, Sumadi Lukman Anwar","doi":"10.37349/etat.2025.1002289","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Telomere length is a potential prognostic biomarker in breast cancer, but its clinical utility remains uncertain due to inconsistent findings across the literature. This systematic review and meta-analysis aims to evaluate the association between telomere length and breast cancer survival outcomes, including overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and recurrence-free survival (RFS).</p><p><strong>Methods: </strong>A systematic search of ten sources, including databases and publishers (JSTOR, Nature, ProQuest, PubMed, Sage Journals, ScienceDirect, Science, Scopus, Springer, and Wiley) was conducted to identify studies published up to December 31, 2023. Studies reporting associations between telomere length and survival outcomes in breast cancer patients were included. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) were extracted or calculated. Quality assessment was performed using the Newcastle-Ottawa Scale, and publication bias was evaluated using funnel plots, Egger's, and Begg's tests.</p><p><strong>Results: </strong>Nine studies involving 3,145 breast cancer patients were included. Shorter telomere length was significantly associated with increased recurrence risk (DFS/RFS) (pooled HR: 1.97; 95% CI: 1.04-3.74, <i>P</i> = 0.039), indicating a nearly twofold increase in risk. Trends toward worse OS (pooled HR: 1.60; 95% CI: 0.90-2.86, <i>P</i> = 0.110) and DSS (pooled HR: 1.09; 95% CI: 0.80-1.49, <i>P</i> = 0.565) were observed, but did not reach statistical significance. Additionally, shorter telomere length was significantly associated with premenopausal status (pooled OR: 1.34; 95% CI: 1.06-1.70, <i>P</i> = 0.01).</p><p><strong>Discussion: </strong>Shorter telomere length is associated with an increased risk of recurrence in breast cancer, highlighting its potential as a prognostic biomarker. However, further research is needed to standardize telomere length measurement methodologies and validate these findings across diverse populations and breast cancer subtypes.</p>","PeriodicalId":73002,"journal":{"name":"Exploration of targeted anti-tumor therapy","volume":"6 ","pages":"1002289"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886381/pdf/","citationCount":"0","resultStr":"{\"title\":\"Shorter telomere length as a prognostic marker for survival and recurrence in breast cancer: a systematic review and meta-analysis.\",\"authors\":\"Dhyas Munandar Arya Sasmita, Kavi Gilang Permana, Teguh Aryandono, Didik Setyo Heriyanto, Sumadi Lukman Anwar\",\"doi\":\"10.37349/etat.2025.1002289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Telomere length is a potential prognostic biomarker in breast cancer, but its clinical utility remains uncertain due to inconsistent findings across the literature. This systematic review and meta-analysis aims to evaluate the association between telomere length and breast cancer survival outcomes, including overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and recurrence-free survival (RFS).</p><p><strong>Methods: </strong>A systematic search of ten sources, including databases and publishers (JSTOR, Nature, ProQuest, PubMed, Sage Journals, ScienceDirect, Science, Scopus, Springer, and Wiley) was conducted to identify studies published up to December 31, 2023. Studies reporting associations between telomere length and survival outcomes in breast cancer patients were included. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) were extracted or calculated. Quality assessment was performed using the Newcastle-Ottawa Scale, and publication bias was evaluated using funnel plots, Egger's, and Begg's tests.</p><p><strong>Results: </strong>Nine studies involving 3,145 breast cancer patients were included. Shorter telomere length was significantly associated with increased recurrence risk (DFS/RFS) (pooled HR: 1.97; 95% CI: 1.04-3.74, <i>P</i> = 0.039), indicating a nearly twofold increase in risk. Trends toward worse OS (pooled HR: 1.60; 95% CI: 0.90-2.86, <i>P</i> = 0.110) and DSS (pooled HR: 1.09; 95% CI: 0.80-1.49, <i>P</i> = 0.565) were observed, but did not reach statistical significance. Additionally, shorter telomere length was significantly associated with premenopausal status (pooled OR: 1.34; 95% CI: 1.06-1.70, <i>P</i> = 0.01).</p><p><strong>Discussion: </strong>Shorter telomere length is associated with an increased risk of recurrence in breast cancer, highlighting its potential as a prognostic biomarker. However, further research is needed to standardize telomere length measurement methodologies and validate these findings across diverse populations and breast cancer subtypes.</p>\",\"PeriodicalId\":73002,\"journal\":{\"name\":\"Exploration of targeted anti-tumor therapy\",\"volume\":\"6 \",\"pages\":\"1002289\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886381/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Exploration of targeted anti-tumor therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.37349/etat.2025.1002289\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Exploration of targeted anti-tumor therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.37349/etat.2025.1002289","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:端粒长度是乳腺癌潜在的预后生物标志物,但由于文献研究结果不一致,其临床应用仍不确定。本系统综述和荟萃分析旨在评估端粒长度与乳腺癌生存结局之间的关系,包括总生存期(OS)、疾病特异性生存期(DSS)、无病生存期(DFS)和无复发生存期(RFS)。方法:系统检索10个来源,包括数据库和出版商(JSTOR、Nature、ProQuest、PubMed、Sage Journals、ScienceDirect、Science、Scopus、施普林格和Wiley),以确定截至2023年12月31日发表的研究。研究报告了端粒长度与乳腺癌患者生存结果之间的关系。提取或计算95%置信区间(CI)的风险比(hr)和优势比(ORs)。使用纽卡斯尔-渥太华量表进行质量评估,使用漏斗图、Egger’s和Begg’s检验评估发表偏倚。结果:纳入了9项研究,涉及3145名乳腺癌患者。较短的端粒长度与复发风险增加显著相关(DFS/RFS)(合并HR: 1.97;95% CI: 1.04-3.74, P = 0.039),表明风险增加了近两倍。OS恶化趋势(合并HR: 1.60;95% CI: 0.90-2.86, P = 0.110)和DSS(合并HR: 1.09;95% CI: 0.80-1.49, P = 0.565),但未达到统计学意义。此外,端粒长度较短与绝经前状态显著相关(合并OR: 1.34;95% ci: 1.06-1.70, p = 0.01)。讨论:较短的端粒长度与乳腺癌复发风险增加有关,突出了其作为预后生物标志物的潜力。然而,需要进一步的研究来标准化端粒长度测量方法,并在不同的人群和乳腺癌亚型中验证这些发现。
Shorter telomere length as a prognostic marker for survival and recurrence in breast cancer: a systematic review and meta-analysis.
Background: Telomere length is a potential prognostic biomarker in breast cancer, but its clinical utility remains uncertain due to inconsistent findings across the literature. This systematic review and meta-analysis aims to evaluate the association between telomere length and breast cancer survival outcomes, including overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and recurrence-free survival (RFS).
Methods: A systematic search of ten sources, including databases and publishers (JSTOR, Nature, ProQuest, PubMed, Sage Journals, ScienceDirect, Science, Scopus, Springer, and Wiley) was conducted to identify studies published up to December 31, 2023. Studies reporting associations between telomere length and survival outcomes in breast cancer patients were included. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) were extracted or calculated. Quality assessment was performed using the Newcastle-Ottawa Scale, and publication bias was evaluated using funnel plots, Egger's, and Begg's tests.
Results: Nine studies involving 3,145 breast cancer patients were included. Shorter telomere length was significantly associated with increased recurrence risk (DFS/RFS) (pooled HR: 1.97; 95% CI: 1.04-3.74, P = 0.039), indicating a nearly twofold increase in risk. Trends toward worse OS (pooled HR: 1.60; 95% CI: 0.90-2.86, P = 0.110) and DSS (pooled HR: 1.09; 95% CI: 0.80-1.49, P = 0.565) were observed, but did not reach statistical significance. Additionally, shorter telomere length was significantly associated with premenopausal status (pooled OR: 1.34; 95% CI: 1.06-1.70, P = 0.01).
Discussion: Shorter telomere length is associated with an increased risk of recurrence in breast cancer, highlighting its potential as a prognostic biomarker. However, further research is needed to standardize telomere length measurement methodologies and validate these findings across diverse populations and breast cancer subtypes.