Role of Cytokines in Breast Cancer: A Systematic Review and Meta-Analysis.

Certainty was rated as moderate to high for IL-6 due to consistent and significant hazard ratios across multiple high-quality studies, while certainty for TNF-α was considered low to moderate due to heterogeneity and borderline significance.

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Elevated IL-6 was consistently associated with poor overall survival (pooled HR = 2.25, 95% CI 1.83–2.76), while high TNF-α levels showed a trend toward worse outcomes but without statistical significance.

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This observation is consistent with our pooled analysis across three clinical studies, which revealed a trend toward increased mortality risk in patients with high TNF-α levels, although the results did not reach statistical significance ( Figure 3 ).

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