the expression of sirtuins in breast cancer and their prognostic and clinicopathological significance: a systematic review

Objectives: sirtuins (sirts) are a highly conserved family of enzymes that play an important role in cancer emergence and progression including breast cancer. in this review, changes in the expression of different sirts in breast cancer and their association with metastasis and cancer grade were investigated. methods: this study was performed on 44 selected articles on breast cancer which were extracted from pubmed, scopus, and web of science. among the selected articles, there were 31 case-control and 13 cohort studies with a total of 7326 and 4760 participants, respectively. results: in most studies sirt1, sirt5, and sirt7 expression levels were higher than the controls, while the expression levels of sirt4 and sirt6 were lower. elevated levels of sirt1 was associated with increased risk of distant metastatic relapse (dmr), death, and recurrence, as well as reduced relapse-free survival (rfs). also, there was a significant correlation between increased levels of sirt1 and metastasis of lymph nodes and other tissues. reduced levels of sirt4 were associated with decreased overall survival (os).conclusion: our findings suggest that the elevated levels of sirt1, sirt5, and sirt7 may have the potential value for use in the diagnosis of breast cancer. increased levels of sirt1 can be used as a prognostic marker.