The prognostic implications of SIRTs expression in breast cancer: a systematic review and meta-analysis

BACKGROUND: Sirtuins (SIRTs) have key roles in cancer progression. However, the prognostic implications of SIRTs in breast cancer (BC) remains a subject of debate and controversy. Thus, we performed a meta-analysis to identify the precise prognostic value of SIRTs in BC patients. METHODS: Systematic literature searching was conducted in PubMed, Cochrane Library, Web of Science, and Embase databases. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to estimate the association of SIRTs expression and survival outcomes in BC patients. RESULTS: A total of 22 original studies with 6317 patients were eligible for this meta-analysis. The results showed that in patients with BC, elevated SIRTs levels were associated with shorter overall survival (OS) and disease-free survival (DFS) both in univariate (HR = 1.56, 95% CI 1.21–2.00; HR = 1.67, 95% CI 1.32–2.12, respectively) and multivariate analysis models (HR = 2.11, 95% CI 1.48–3.00; HR = 1.70, 95% CI 1.20–2.39, respectively). Notably, further subgroup analysis revealed that overexpression of SIRT1 and SIRT6 predicted poor OS (HR = 2.65, 95% CI 1.54–4.56; HR = 2.53, 95% CI 1.64–3.90, respectively) and DFS (HR = 1.65, 95% CI 1.07–2.56; HR = 2.74; 95% CI 1.88–4.01, respectively) in BC. CONCLUSIONS: Our data has elucidated that SIRT1 and SIRT6 could serve as prognostic biomarkers for patients with BC and may contribute to refined patient management. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12672-022-00529-7.