![]() ![]() We searched relevant articles in PubMed, Embase, Cochrane, and the Ovid Medline database up to July 2017 without language or date restrictions. 2 Methods 2.1 Search strategy and study selectionĪs this literature is a meta-analysis, ethical approval is not necessary. The aim of this meta-analysis was to clarify the predictive and prognostic role of cfDNA in patients with breast cancer. However, such studies are conflicting in their results, and have not been systematically reviewed. In addition, several studies have indicated that the levels of circulating cfDNA, methylation of cfDNA, loss of heterozygosity (LOH) of cfDNA, and cfDNA integrity are associated with disease outcome of breast cancer patients. Furthermore, many studies have reported the prognostic value of cfDNA in various kinds of solid neoplasm, including lung cancer, pancreatic cancer, prostate cancer, hepatocellular cancer, renal cell cancer, colorectal cancer, and breast cancer. High concentrations and genetic alterations of cfDNA are revealed to be more likely present in cancer patients as compared to healthy controls. The occurrence of circulating cfDNA is thought to be related to the apoptosis and necrosis of cells. Therefore, new prognostic biomarkers are urgently needed to monitor the progression of breast cancer.Ĭirculating cell-free DNA (cfDNA), a type of cell-free nucleic acids, is defined as extracellular DNA in the blood. However, these serum biomarkers have limited usefulness due to their low sensitivity and specificity. In clinical practice, serum markers such as carbohydrate antigen (CA) 15-3, BR 27.29, mucin-like cancer-associated antigen, CA549, and carcinoembryonic antigen are the most common prognostic factors for monitoring patients and predicting their risk of relapse. Thus, estimating relapse and monitoring metastases could contribute to a better outcome and improve quality of life for breast cancer patients. Although radical surgery, radiotherapy, and drug therapy have significantly reduced the risk of relapse and improved overall survival of breast cancer patients, a certain percentage of patients still develop early tumor recurrent or progression. However, further studies are needed to confirm our results.īreast cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death among women in the worldwide. ![]() Our meta-analysis indicated that cfDNA was associated with poor PFS and OS, thus it may help to predict outcomes of patients with breast cancer. The results of subgroup analyses also revealed that cfDNA was a good predictor of prognosis in breast cancer patients. cfDNA was shown to be significantly associated with PFS (HR 2.02, 95% CI 1.51–2.72, P <. Results:Ī total of 11 publications involving 1467 patients were included in this meta-analysis. The hazard ratios (HRs) and their 95% confidence intervals (95% CIs) were extracted to assess the prognostic significance of cfDNA. The end points were progression-free survival (PFS) and overall survival (OS). We performed systematic searches in electronic databases to identify studies that evaluated the prognostic value of cfDNA in breast cancer patients. In this meta-analysis, we evaluated the prognostic role of cfDNA in breast cancer patients. ![]() However, its prognostic value in patients with breast cancer is not well established still now. Ĭirculating cell-free DNA (cfDNA) has been reported to predict outcomes in patients with various types of cancer. The work cannot be changed in any way or used commercially without permission from the journal. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website ( This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Supplemental digital content is available for this article. Supplemental Digital Content is available for this article. The authors declare no conflicts of interest. JY, LC, and XM contributed equally to this work. 37, Guo Xue Alley, Chengdu 610041, PR China (e-mail: ).Ībbreviations: CA = carbohydrate antigen, cfDNA = cell-free DNA, CIs = confidence intervals, HR = hazard ratio, HRs = hazard ratios, LOH = loss of heterozygosity, NOS = Newcastle–Ottawa Quality Assessment Scale, OS = overall survival, PFS = progression-free survival, TNM stage = tumor-node-metastasis stage. AState Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Collaborative Innovation Center for Biotherapy, ChengduīWest China School of Stomatology Sichuan University, Chengdu, China.Ĭorrespondence: Xuelei Ma, West China Hospital, No. ![]()
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