| Objective: A number of studies have shown that LncRNAs are abnormally expressed in a variety of cancers.However,the roles of LncRNAs remain unclear in breast cancer.here,a comprehensive study of the diagnostic,prognostic,and clinical features of LncRNAs in breast cancer will be analyzed by meta-analysis.Methods:(1)Literature Retrieval: A comprehensive collection of literatures on the LncRNAs which are related to breast cancer over the past five years(2013.1-2018.3)is finished by the databases,web of science and pubmed,using a search method of combination of keywords and free-words.(2)Document Screening: Duplicate documents are automatically identified by ENDNOTE,and remained documents which are not recognized by ENDNOTE will be removed manually.By reading the titles and abstracts of each article,we preliminarily exclude non-related studies,and further exclude the review,the paper of meta-analysis and the literature that does not provide valid data through full-text reading.(3)Data Extraction: Collect general information such as the name of the author,the year of publication,the area of study,sample size,molecular types,etc.1.Use two-by-two tables to extract specificity and sensitivity to assess the accuracy of diagnostic test.2.HRs and 95%CI are indirectly extracted to evaluate prognosis.3.Clinical features are selected as follows: age,tumor size,whether or not menopause,whether or not lymph node metastasis,the expression of ER(estrogen receptor),PR(progesterone receptor),HER2(epidermal growth factor receptor)and so on.(4)Meta Analysis: Review Manager 5.2 and Meta-Disc 1.4 are used for data analysis,and STATA 12.0 for sensitivity analysis and publication bias evaluation.The combination of sen and spe is used to evaluate the diagnostic value of LncRNAs.Combination of HR and 95%CI is used to assess the risk of LncRNAs in OS,RFS,PFS of breast cancer.For example,HR > 1 indicates that the low expression group has a better prognosis.ORs and it’s 95%CI are used to evaluate the distribution of the expression of LncRNAs in clinical features of breast cancer.For all the analysis,P < 0.05.Heterogeneity was assessed by using Q and I2 analysis.P<0.1 indicates presence of heterogeneity and I2>50% indicates significant heterogeneity.Results: A total of 32 studies including 4608 patients with breast cancer are included.LncRNAs diagnostic tests are conducted in 5 studies and prognostic characteristics of LncRNAs in breast cancer are analyzed in 21 studies.Among them,24 studies provides clinical classification data.The sensitivity,specificity,DOR(diagnostic odds ratio)and AUC summarized in the diagnostic tests are as follows in all LncRNAs: 0.75 [95% CI:0.72-0.78]、0.84 [95% CI: 0.81-0.87]、17.83 [95% CI: 13.27-23.23] and 0.8705.Abnormally expressed LncRNAs found in the study of prognosis are associated with OS,RFS,PFS.The HR of the up-regulated group are higher than 1,which indicates that the high expression of LncRNAs suggests a worse prognosis,in the low expression group,the opposite result is obtained.In clinical feature Meta analysis,the expression of LncRNAs is positively correlated with lymph node metastasis,tumor size and ER expression in up-regulated group.However,in down-regulated group,the expression is negatively correlated with lymph node metastasis and tumor size,but positively correlated with the expression of HER2.Conclusion: LncRNAs have potential diagnostic value in breast cancer.Meanwhile,High expression of LncRNAs was associated with poor prognosis(OS、RFS and PFS).While,in the down-regulated group,the low expression of LncRNAs suggests a better prognosis. |
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