title: Prognostic value of stromal decorin expression in patients with breast cancer: a meta-analysis.
abstract: BACKGROUND
  Numbers of studies have investigated the biological functions of decorin (DCN) in oncogenesis, tumor progression, angiogenesis and metastasis. Although many of them aim to highlight the prognostic value of stromal DCN expression in breast cancer, some controversial results still exist and a consensus has not been reached until now. Therefore, our meta-analysis aims to determine the prognostic significance of stromal DCN expression in breast cancer patients.
  
  
  METHODS
  PubMed, EMBASE, the Web of Science and China National Knowledge Infrastructure (CNKI) databases were searched for full-text literatures met out inclusion criteria. We applied the hazard ratio (HR) with 95% confidence interval (CI) as the appropriate summarized statistics. Q-test and I(2) statistic were employed to estimate the level of heterogeneity across the included studies. Sensitivity analysis was conducted to further identify the possible origins of heterogeneity. The publication bias was detected by Begg's test and Egger's test.
  
  
  RESULTS
  There were three English literatures (involving 6 studies) included into our meta-analysis. On the one hand, both the summarized outcomes based on univariate analysis (HR: 0.513; 95% CI: 0.406-0.648; P<0.001) and multivariate analysis (HR: 0.544; 95% CI: 0.388-0.763; P<0.001) indicated that stromal DCN expression could promise the high cancer-specific survival (CSS) of breast cancer patients. On the other hand, both the summarized outcomes based on univariate analysis (HR: 0.504; 95% CI: 0.389-0.651; P<0.001) and multivariate analysis (HR: 0.568; 95% CI: 0.400-0.806; P=0.002) also indicated that stromal DCN expression was positively associated with high disease-free survival (DFS) of breast cancer patients. No significant heterogeneity or publication bias was observed within this meta-analysis.
  
  
  CONCLUSIONS
  The present evidences indicate that high stromal DCN expression can significantly predict the good prognosis in patients with breast cancer. The discoveries from our meta-analysis have better be confirmed in the updated review pooling more relevant investigations in the future.
authors.affiliation: 1 Department of Thoracic Surgery, 2 Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Shuang-Jiang
authors.initials: SJ
authors.lastname: Li
authors.affiliation: 1 Department of Thoracic Surgery, 2 Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Da-Li
authors.initials: DL
authors.lastname: Chen
authors.affiliation: 1 Department of Thoracic Surgery, 2 Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Wen-Biao
authors.initials: WB
authors.lastname: Zhang
authors.affiliation: 1 Department of Thoracic Surgery, 2 Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Shen
authors.affiliation: 1 Department of Thoracic Surgery, 2 Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: Che
keywords: Decorin (DCN); breast cancer; meta-analysis; prognosis