摘要目的 评价乳腺癌患者p27Kip1蛋白表达与其预后的关系.方法 计算机检索相关文献,按纳入和排除标准筛选文献,采用Revman 4.2软件进行Meta分析,并按是否淋巴结转移进行分层分析.结果 有20篇文献符合要求,包括患者人数共6457个.对乳腺癌患者总生存率合并风险比(RR)值为2.07[1.66,2.60](P＜0.01),无病生存率合并RR值为1.27[1.10,1.47](P＜0.05),无复发生存率合并RR值为1.49[0.92,2.42](P＞0.05);根据淋巴结转移情况进行分层分析:淋巴结阴性组总生存率合并RR值分别为1.98[1.34,2.91](P＜0.01),淋巴结阳性组总生存率合并RR值是1.92[1.31,2.82](P=0.0009);淋巴结阴性组无复发生存率合并RR值为1.28[0.45,3.65](P＞0.05);淋巴结阳性组无复发生存率合并RR值1.35[0.96,1.89](P＞0.05).结论 p27Kip1可能是乳腺癌患者总生存率、无病生存率的独立预后因素,但对无复发生存率是否有预测意义尚缺乏足够数据支持.

abstractsObjective To evaluate the relationship between p27Kip1 low expression in breast cancer and its prognostic implication in breast carcinoma patients.Methods All data that were associated with the study of the relationship between p27Kip1 and the prognosis for breast cancer was pooled from Cochrane library,PubMed,Embase and Medlinebase.The outcome was measured using the risk ratio(RR).Data pooling was performed by RevMan 4.2.Results 6457 patients from 20 studies were included in this metaanalysis.RR estimate of overall survival(OS)for patients with low level p27Kip1 was 2.07[1.66,2.60](P ＜ 0.01).For disease free survival(DFS),the pooled RR was 1.27[1.10,1.47](P＜0.05).The combined RR estimate of relapse free survival(RFS)for patients with low level of p27Kip1 was 1.49[0.92,2.42](P ＞ 0.05).In patients with lymph node negative breast carcinoma,the combined RR for OS and RFS were 1.98[1.34,2.91](P＜0.01)and 1.28[0.45,3.65](P＞0.05),respectively.Among the patients with lymph node positive breast carcinoma,the combined RR for OS and RFS was 1.92[1.3 1,2.82](P=0.0009)and 1.35[0.96,1.89](P＞0.05)respectively.Conclusions Low level of p27Kip1 appears to be an independent prognostic factor to OS and DFS of breast cancer patients but not to RFS.Additional studies with large patient number and widely accepted practical methods are required to derive the precise prognostic significance of p27Kip1 expression in breast cancer patients.