Abstract
Glioma-associated oncogene 1 (Gli1) is a critical transcriptional factor of Sonic hedgehog pathway which has been proved to participate in the initiation and progression of tumor in mammalians. However, its clinical value in breast cancer remains unknown. Thus, a meta-analysis was performed to clarify the association of Gli1 over-expression, clinic-pathological characteristics, molecular subtypes and prognosis in breast cancer. According to included criteria, 13 eligible studies containing 2816 patients all around the world were selected in this study. Our results indicated no significant association of Gli1 expression and histological grade (RR = 1.20, 95% CI: [0.98, 1.47]), T stage (RR = 1.05, 95% CI: [0.87, 1.27]), clinical stage (RR = 1.04, 95% CI: [0.93, 1.18]) and lymph node metastasis (RR = 1.12, 95% CI: [0.92, 1.37]). In addition, pooled RR showed no correlation of Gli1 expression and progesterone receptor (PR) (RR = 0.92, 95% CI: [0.70, 1.21]), estrogen receptor (ER) (RR = 1.03, 95% CI: [0.74, 1.42]), human epidermal growth factor receptor 2 (HER-2) (RR = 1.12, 95% CI: [0.90, 1.39]). Nonetheless, up-regulated Gli1 expression predicts shorter disease-free survival (DFS) (HR = 1.38, 95% CI: [1.05, 1.81]), 3-year survival (HR = 1.74, 95% CI: [1.28, 2.36]), 5-year survival (HR = 2.04, 95% CI: [1.62, 2.57]) and overall survival (OS) (HR = 2.05, 95% CI: [1.60, 2.64]). In conclusion, over-expression of Gli1 tends to progressive stages and is related to unfavorable prognosis of breast cancer, which may become a potential prognosis indicator and therapy target in breast cancer.
Highlights
Worldwide, morbidity of breast cancer has been increased to 1.7 million in 2012
It involves in the formation and progression of breast cancer in many important ways such as activating tumor associated target genes [36, 37], promoting mammary epithelial cell mesenchymal transition (EMT) [38], regulating mammary cancer stem cells (CSC) self-renewal [10] and facilitating angiogenesis [39]
In www.impactjournals.com/oncotarget www.impactjournals.com/oncotarget addition, researchers have confirmed that inhibiting the Glioma-associated oncogene 1 (Gli1) expression could effectively attenuate tumor growth and migration and indicated its potential role as a therapeutic target in breast cancer management [40, 41]
Summary
Morbidity of breast cancer has been increased to 1.7 million in 2012. For females, breast cancer has the highest mortality rate among all cancer types, accounting for 15% of all cancer deaths [1]. More effective therapeutic strategies of breast cancer underlie a better understanding of novel molecular targets and signaling pathways that are closely related to the clinic-pathological prognostic factors of breast cancer. Several types of carcinoma have been reported to have aberrant activation of Gli, including hepatocellular carcinoma, gastric cancer, lung cancer, breast cancer and basal cell carcinoma, indicating the dysregulation of Gli may contribute to malignant biological behavior [14,15,16]. Some studies have indicated that overexpression of Gli predicted poor outcome of breast cancer with higher tumor stage and increased number of tumor-positive axillar lymph nodes [19, 20]. To clarify the association of Gli overexpression and clinicopathological features, molecular subtypes, and clinical outcomes in breast cancer, a metaanalysis was performed via acquired available published data
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