Abstract
Objectives: The invasive breast cancer is divided into four clinical subtypes: Luminal A-like, Luminal B-like, HER-2 positive, and triple-negative according to the expression status of estrogen receptor (ER), progesterone receptor(PR), human epidermal growth factor receptor-2 (HER-2) and Ki-67. The prognosis and treatment strategy vary with subtypes. The current studies have reported the relation between lymphatic vessel invasion (LVI) and the expression status of ER, PR, HER-2, Ki-67 in invasive breast cancer, but the results were debatable. So the meta-analysis was conducted to confirm the relation between LVI and the four factors. Methods: Literature was searched by entering the terms: breast AND (neoplasm OR cancer OR carcinoma) AND (lymphovascular OR “lymph vessel” OR “lymphatic vessel” invasion OR carcinoma embolus) AND (ER OR estrogen receptor OR PR OR progesterone receptor OR HER-2 OR human epidermal growth factor receptor-2 OR Ki-67 OR clinicopathological) in Pubmed. The merged odds ratio (OR) and 95% confidence interval (CI) were estimated using fixed-effect model. Review Manager 5.2 was used to analysis the relation between LVI and the expression status of ER, PR, HER-2, Ki-67 in invasive breast cancer respectively. The fail-safe number was used to estimate publication bias. Results: The analysis included 5 studies, LVI positive rate was significant lower in ER positive, PR positive, HER-2 negative, low Ki-67 expression group statistically. The OR and 95% CI were 0.6(0.44 - 0.81), 0.64(0.43 - 0.95), 1.52(1.03 - 2.24), 5.29(1.53 - 18.35) respectively.Conclusions: LVI was significantly correlated with the expression status of ER, PR, HER-2 and Ki-67 in invasive breast cancer. Furthermore, LVI was consistent with poor prognostic expression status of the four factors.
Highlights
Breast cancer is a common cancer in female and one of the leading causes of cancer death in women
Literature Search Strategy Literature was searched by entering the terms: breast AND AND AND (ER odds ratio (OR) PR OR estrogen receptor OR progesterone receptor OR HER-2 OR human epidermal growth factor receptor-2 OR Ki-67 OR clinicopathological) in Pubmed
A total of 425 articles were identified from Pubmed, 17 articles were remained after exclusion based on the titles and abstracts. 1 duplication, 2 original articles in Chinese language, 1 original article in Portuguese language, 2 articles that could not provided interested data, 3 articles in which lymphatic vessel invasion (LVI) was detected by HE and 3 original full texts that could not be obtained were removed
Summary
Breast cancer is a common cancer in female and one of the leading causes of cancer death in women. It accounts for 29% of all female new cancers and 15% of all female deaths due to cancers [1]. LVI is a key step of tumor cells reaching lymph node, LVI is known as an independent predictor of lymph node metastases. Lymph node-positive breast cancer has a poor prognosis. Most studies have found that LVI is a promising predictor, but the results are often conflicting. LVI wis presented as an independent predictor of disease-free survival (DFS) as well as overall survival (OS) [2] [3]. Gallen consensus guidelines suggested LVI was recognized as one of the factors upon which to base treatment plan decisions [4]
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