title: Prediction of poor prognosis in breast cancer patients based on microRNA-21 expression: a meta-analysis.
abstract: BACKGROUND
  MicroRNA-21 (miRNA-21 or miR-21) may act as a prognostic biomarker of cancer. However, the available evidence is controversial. Therefore, the present meta-analysis summarizes this evidence and evaluates the prognostic role of this gene in breast cancer.
  
  
  METHODS
  The meta-analysis was conducted by searching the databases of PubMed, EMBASE, Web of Science and Chinese database-China National Knowledge Infrastructure (CNKI). Data were extracted from studies that investigated the association between miR-21 expression and survival outcomes in breast cancer patients. With respect to survival outcomes, the pooled hazard ratios (HRs) of miR-21 were calculated given a 95% confidence interval (CI).
  
  
  RESULTS
  Our meta-analysis identified a total of 10 studies involving 1,439 cases. Further investigation demonstrated that a high miR-21 expression can predict poor overall survival (OS) (HR = 2.57, 95% CI: 1.37-4.81, P = 0.003) and shortened disease-free/recurrence-free survival (DFS/RFS) (HR = 1.45, 95% CI: 1.16-1.82, P = 0.001) in breast cancer patients. Moreover, high miR-21 expression was significantly correlated with lowered OS in the Asian group (HR = 5.07, 95% CI: 2.89-8.92, P < 0.001), but not in the Caucasian cohort (HR = 1.44, 95% CI: 0.99-2.10, P = 0.058). Furthermore, odds ratios (ORs) showed that up-regulated miR-21 levels were associated with multiple clinical characteristics.
  
  
  CONCLUSIONS
  Our results indicated that miR-21 can predict unfavorable prognoses in breast cancer patients, especially in Asians.
authors.affiliation: Department of Surgical Oncology, Second Affiliated Hospital, Medicine School of Zhejiang University, Hangzhou, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital, Medicine School of Zhejiang University, Hangzhou, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Cancer Institute, Second Affiliated Hospital, Medicine School of Zhejiang University, Hangzhou, China.
authors.forename: Chi
authors.initials: C
authors.lastname: Pan
authors.affiliation: Department of Surgical Oncology, Second Affiliated Hospital, Medicine School of Zhejiang University, Hangzhou, China.
authors.forename: Feixia
authors.initials: F
authors.lastname: Ma
authors.affiliation: Department of Surgical Oncology, Second Affiliated Hospital, Medicine School of Zhejiang University, Hangzhou, China.
authors.forename: Suzhan
authors.initials: S
authors.lastname: Zhang
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology; D005260:Female; D006801:Humans; D035683:MicroRNAs / Q000235:genetics*; D011379:Prognosis
chemical_list: C524940:MIRN21 microRNA, human; D035683:MicroRNAs