Prognostic value of progesterone receptor in ovarian cancer: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

DONG Xiaoli ,  ZHENG Hong

Department of Pathology, the affiliated Hospital of Zunyi Medical University, Zunyi, 563000, P.R China;

Corresponding author：

Keywords：

Ovrian cancer; Progesterone receptor; Prognostic factor; Meta-analysis

DOI：

10.7507/1672-2531.201608021

Video：

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Objective To systematically review the prognostic value of progesterone receptor (PR) for survival in ovarian cancer. Methods PubMed, EMbase, MEDLINE, The Cochrane Library (Issue 1, 2016), CNKI, VIP, CBM and WanFang Data databases were searched for cohort studies on the correlation between PR expression and prognosis of ovarian cancer from inception to June 1^st 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 12 studies involving 1 881 patients were included. The results of meta-analysis showed that the PR positive patients was superior than the PR negative patients on overall survival (OS) (HR=0.64, 95%CI 0.44 to 0.93,P=0.02), disease free survival (DFS) (HR=0.64, 95%CI 0.48 to 0.85,P=0.002), progression free survival (PFS) (HR=0.62, 95%CI 0.47 to 0.82,P=0.000 9) and remission rate of chemotherapy (OR=1.91, 95%CI 1.28 to 2.86,P=0.002). When analysis based on the clinical pathogesis stages, PR expression was higher in clinical stages Ⅰ-Ⅱ than stage Ⅲ-Ⅳ (OR=2.38, 95%CI 1.71 to 3.32,P<0.000 01), and was higher in cell differentiation G1-G2 than G3 (OR=2.48, 95%CI 1.72 to 3.56,P<0.000 01), while no significant difference was found in groups of serous ovarian cancervs. non serous ovarian cancer (OR=1.28, 95%CI 0.89 to 1.83,P=0.18). Conclusion The current evidence shows that the expression of PR protein have predictive value for the prognosis of ovarian cancer. Due to limited quantity and quality of included studies, the above conclusions are still needed to verified by more high quality studies.

Citation： DONG Xiaoli, ZHENG Hong. Prognostic value of progesterone receptor in ovarian cancer: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(3): 327-333. doi: 10.7507/1672-2531.201608021 Copy

1.	Trojanek J. Matrix metalloproteinases and their tissue inhibitors. Postepy Biochem, 2012, 58(3): 353-362.
2.	Proveda VA, Casado HA, Gervantes RA,et al. Treatment guidelines in ovarian cancer. Clin Transl Oncol, 2007, 9(5): 308-316.
3.	Howell A, Robertson JF, Abram P,et al. Comparison of fulvestrant versus tamoxifen for the treatment of advanced breast cancer inpostmenopausal womenpreviously untreated with endocrine therapy: a multinational, double-blind, randomized trial. J Clin Oncol, 2004, 22(16): 5-13.
4.	Fisher B, Costantino JP, Wickerham DL,et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer inst, 1998, 90(18): 1371-1388.
5.	Bardou VJ, Arpino G, Elledge RM,et al. Progesterone receptor status significantly improves outcome prediction over estrogen receptor status alone for adjuvant endocrine therapy in two large breast cancer databases. J Clin Oncol, 2003, 21(10): 1973-1979.
6.	Lee P, Rosen DG, Zhu C,et al. Expression of progesterone receptor is a favorable prognostic marker in ovarian cancer. Gynecol Oncol, 2005, 96(3): 671-677.
7.	周支瑞, 张天崇, 李博, 等. 生存曲线中 Meta 分析适宜数据的提取与转换. 中国循证心血管医学杂志, 2014, 6(3): 243-247.
8.	Wells GA, Shea B, O’connell D,et al. The Newcastle-Ottawa Scale (NOS) for assessing the guality if nonrandomized studies in meta-analysis [EB/OL]. 2015, 5: 26.
9.	Lenhard M, Tereza L, Heublein S,et al. Steroid hormone receptor expression in ovarian cancer: progesterone receptor B as prognostic marker for patient survival. BMC Cancer, 2012, 12: 553.
10.	Kommoss F, Pfisterer J, Thome M,et al. Steroid Receptors in Ovarian Carcinoma: immunohistochemical Determination May Lead to New Aspects. Gynecol Oncol, 1992, 47(3): 317-322.
11.	Scambia G, Benedetti-Panici P, Ferrandina G,et al. Epidermal growth factor, oestrogen and progesterone receptor expression in primary ovarian cancer: correlation with clinical outcome and response to chemotherapy. Br J Cancer, 1995, 72(2): 361-366.
12.	Lee P, Rosen DG, Zhu C,et al. Expression of progesterone receptor is a favorable prognostic marker in ovarian cancer. Gynecol Oncol, 2005, 96(3): 671-677.
13.	García-Velasco A, Mendiola C, Sánchez-Muñoz A,et al. Prognostic value of hormonal receptors, p53, ki67 and HER2/neu expression in epithelial ovarian carcinoma. Clin Transl Oncol, 2008, 10(9): 367-371.
14.	Yang XY, Xi MR, Yang K,et al. Prognostic value of estrogen receptor and progesterone receptor status in young Chinese ovarian carcinoma patients. Gynecol Oncol, 2009, 113(1): 99-104.
15.	Buchynska LG, iurchenko NP, Grinkevych VM,et al. Expression of the estrogen and progesterone receptors as prognostic factor in serous ovarian ancers. Exp Oncol, 2009, 31(1): 48-51.
16.	Tangjitgamol S, Manusirivithaya S, Khunnarong J,et al. Expressions of Estrogen and Progesterone Receptors in Epithelial Ovarian Cancer: A Clinicopathologic Study. Int J Gynecol Cancer, 2009, 19(4): 620-627.
17.	De Stefano I, Zannoni GF, Prisco MG,et al. Cytoplasmic expression of estrogen receptor beta (ERβ) predicts poor clinical outcome in advanced serous ovarian cancer. Gynecol Oncol, 2011, 122(3): 573-579.
18.	Battista MJ, Mantai N, Sicking I,et al. Ki-67 as an independent prognostic factor in an unselected cohort of patients with ovarian cancer: Results of an explorative, retrospective study. Oncol Rep, 2014, 31(5): 2213-2219.
19.	Tkalia IG, Vorobyova LI, Svintsitsky VS,et al. Clinical significance of hormonal receptor status of malignant ovarian tumors. Exp Oncol, 2014, 36(2): 125-133.
20.	Jatoi A, Vierkant RA, Hawthorne KM,et al. Clinical and Emergent Biomarkers and Their Relationship to the Prognosis of ovarian Cancer. Oncology, 2015, 90(2): 59-68.
21.	Jönsson JM, Skovbjerg AN, Malander Sr,et al. Sex steroid hormone receptor expression affects ovarian cancer surviva. Transl Oncol, 2015, 8(5): 424-433.
22.	Harding M, Cowan S, Hole D,et al. Estrogen and progesterone receptor in ovarian cancer. Cancer, 1990, 65(3): 486-491.
23.	Langdon SP, Gabra H, Bartlett JM. Functionality of the progester-one receptor in ovarian cancer and its regulation by estrogen. Clin Cancer Res, 1998, 4(9): 2245-2251.
24.	Wu H, Wang K, Liu W,et al. PTEN overexpression improves cisplatin resistance of human ovarian cancer cells though upregulating KRT10 expression. Biochem Biophys Res Commun, 2014, 444(2): 141.
25.	Geisler JP, Wiemann MC, Miller GA,et al. Estogen and progesterone receptor status as prognostic indicators in patients with optimally cytoreduced stage IIIc serous cystadenocarinoma of the ovary. Gynecol Oncol, 1996, 60(3): 424-427.

1. Trojanek J. Matrix metalloproteinases and their tissue inhibitors. Postepy Biochem, 2012, 58(3): 353-362.
2. Proveda VA, Casado HA, Gervantes RA,et al. Treatment guidelines in ovarian cancer. Clin Transl Oncol, 2007, 9(5): 308-316.
3. Howell A, Robertson JF, Abram P,et al. Comparison of fulvestrant versus tamoxifen for the treatment of advanced breast cancer inpostmenopausal womenpreviously untreated with endocrine therapy: a multinational, double-blind, randomized trial. J Clin Oncol, 2004, 22(16): 5-13.
4. Fisher B, Costantino JP, Wickerham DL,et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer inst, 1998, 90(18): 1371-1388.
5. Bardou VJ, Arpino G, Elledge RM,et al. Progesterone receptor status significantly improves outcome prediction over estrogen receptor status alone for adjuvant endocrine therapy in two large breast cancer databases. J Clin Oncol, 2003, 21(10): 1973-1979.
6. Lee P, Rosen DG, Zhu C,et al. Expression of progesterone receptor is a favorable prognostic marker in ovarian cancer. Gynecol Oncol, 2005, 96(3): 671-677.
7. 周支瑞, 张天崇, 李博, 等. 生存曲线中 Meta 分析适宜数据的提取与转换. 中国循证心血管医学杂志, 2014, 6(3): 243-247.
8. Wells GA, Shea B, O’connell D,et al. The Newcastle-Ottawa Scale (NOS) for assessing the guality if nonrandomized studies in meta-analysis [EB/OL]. 2015, 5: 26.
9. Lenhard M, Tereza L, Heublein S,et al. Steroid hormone receptor expression in ovarian cancer: progesterone receptor B as prognostic marker for patient survival. BMC Cancer, 2012, 12: 553.
10. Kommoss F, Pfisterer J, Thome M,et al. Steroid Receptors in Ovarian Carcinoma: immunohistochemical Determination May Lead to New Aspects. Gynecol Oncol, 1992, 47(3): 317-322.
11. Scambia G, Benedetti-Panici P, Ferrandina G,et al. Epidermal growth factor, oestrogen and progesterone receptor expression in primary ovarian cancer: correlation with clinical outcome and response to chemotherapy. Br J Cancer, 1995, 72(2): 361-366.
12. Lee P, Rosen DG, Zhu C,et al. Expression of progesterone receptor is a favorable prognostic marker in ovarian cancer. Gynecol Oncol, 2005, 96(3): 671-677.
13. García-Velasco A, Mendiola C, Sánchez-Muñoz A,et al. Prognostic value of hormonal receptors, p53, ki67 and HER2/neu expression in epithelial ovarian carcinoma. Clin Transl Oncol, 2008, 10(9): 367-371.
14. Yang XY, Xi MR, Yang K,et al. Prognostic value of estrogen receptor and progesterone receptor status in young Chinese ovarian carcinoma patients. Gynecol Oncol, 2009, 113(1): 99-104.
15. Buchynska LG, iurchenko NP, Grinkevych VM,et al. Expression of the estrogen and progesterone receptors as prognostic factor in serous ovarian ancers. Exp Oncol, 2009, 31(1): 48-51.
16. Tangjitgamol S, Manusirivithaya S, Khunnarong J,et al. Expressions of Estrogen and Progesterone Receptors in Epithelial Ovarian Cancer: A Clinicopathologic Study. Int J Gynecol Cancer, 2009, 19(4): 620-627.
17. De Stefano I, Zannoni GF, Prisco MG,et al. Cytoplasmic expression of estrogen receptor beta (ERβ) predicts poor clinical outcome in advanced serous ovarian cancer. Gynecol Oncol, 2011, 122(3): 573-579.
18. Battista MJ, Mantai N, Sicking I,et al. Ki-67 as an independent prognostic factor in an unselected cohort of patients with ovarian cancer: Results of an explorative, retrospective study. Oncol Rep, 2014, 31(5): 2213-2219.
19. Tkalia IG, Vorobyova LI, Svintsitsky VS,et al. Clinical significance of hormonal receptor status of malignant ovarian tumors. Exp Oncol, 2014, 36(2): 125-133.
20. Jatoi A, Vierkant RA, Hawthorne KM,et al. Clinical and Emergent Biomarkers and Their Relationship to the Prognosis of ovarian Cancer. Oncology, 2015, 90(2): 59-68.
21. Jönsson JM, Skovbjerg AN, Malander Sr,et al. Sex steroid hormone receptor expression affects ovarian cancer surviva. Transl Oncol, 2015, 8(5): 424-433.
22. Harding M, Cowan S, Hole D,et al. Estrogen and progesterone receptor in ovarian cancer. Cancer, 1990, 65(3): 486-491.
23. Langdon SP, Gabra H, Bartlett JM. Functionality of the progester-one receptor in ovarian cancer and its regulation by estrogen. Clin Cancer Res, 1998, 4(9): 2245-2251.
24. Wu H, Wang K, Liu W,et al. PTEN overexpression improves cisplatin resistance of human ovarian cancer cells though upregulating KRT10 expression. Biochem Biophys Res Commun, 2014, 444(2): 141.
25. Geisler JP, Wiemann MC, Miller GA,et al. Estogen and progesterone receptor status as prognostic indicators in patients with optimally cytoreduced stage IIIc serous cystadenocarinoma of the ovary. Gynecol Oncol, 1996, 60(3): 424-427.

Chinese Journal of Evidence-Based Medicine

Prognostic value of progesterone receptor in ovarian cancer: a meta-analysis

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