title: The prognostic value of phosphorylated Akt in breast cancer: a systematic review.
abstract: The prognostic value of phosphorylated Akt (pAkt) overexpression in breast cancer has been investigated by many studies with inconsistent results. This systematic review was conducted to evaluate the association of pAkt overexpression with breast cancer prognosis in terms of overall survival and disease-free survival. Three electronic databases (PubMed, EMBASE and Chinese Biomedical Literature Database) were comprehensively searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) from different studies were combined using the random-effects model. In total, 33 studies with 9,836 patients were included for final analysis. The summary HR for overall survival and disease-free survival was 1.52 (95% CI: 1.29-1.78) and 1.28 (95% CI: 1.13-1.45), respectively, indicating higher risk of death and disease recurrence associated with pAkt overexpression. The results were robust in sensitivity analyses by omitting one study each time and by using the fixed-effects model instead. Subgroup and meta-regression analyses did not show that the prognostic effect of pAkt overexpression would change materially with such factors as population, status of hormone receptors, hormonal or trastuzumab treatment given, analyzing method (univariate versus multivariate) and methodological quality of the original studies. In conclusion, the available evidence suggests that pAkt overexpression is an adverse prognostic factor for breast cancer.
authors.affiliation: Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Zu-Yao
authors.initials: ZY
authors.lastname: Yang
authors.affiliation: Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Meng-Yang
authors.initials: MY
authors.lastname: Di
authors.affiliation: Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Jin-Qiu
authors.initials: JQ
authors.lastname: Yuan
authors.affiliation: Cancer Institute, Shenzhen People's Hospital (2nd Clinical Medical College of Jinan University), Shenzhen, Guangdong Province, China.
authors.forename: Wei-Xi
authors.initials: WX
authors.lastname: Shen
authors.affiliation: Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Da-Yong
authors.initials: DY
authors.lastname: Zheng
authors.affiliation: Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
authors.forename: Jin-Zhang
authors.initials: JZ
authors.lastname: Chen
authors.affiliation: 1] Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong [2] Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, Guangdong Province, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Mao
authors.affiliation: 1] Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong [2] Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, Guangdong Province, China [3] The Hong Kong Branch of The Chinese Cochrane Centre, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Jin-Ling
authors.initials: JL
authors.lastname: Tang
mesh_terms: D001943:Breast Neoplasms / Q000201:enzymology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010766:Phosphorylation; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism*; D017594:Publication Bias; D012044:Regression Analysis
chemical_list: D051057:Proto-Oncogene Proteins c-akt