Prognostic significance of p53 alterations in patients with non-small celllung cancer: A meta-analysis

Citation
T. Mitsudomi et al., Prognostic significance of p53 alterations in patients with non-small celllung cancer: A meta-analysis, CLIN CANC R, 6(10), 2000, pp. 4055-4063
Citations number
82
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology
Journal title
CLINICAL CANCER RESEARCH
ISSN journal
1078-0432 → ACNP
Volume
6
Issue
10
Year of publication
2000
Pages
4055 - 4063
Database
ISI
SICI code
1078-0432(200010)6:10<4055:PSOPAI>2.0.ZU;2-P
Abstract
There is great controversy as to whether alteration of the p53 gene adverse ly affects survival of non-small cell lung cancer patients. The aim of this study was to qualitatively review the association between p53 alterations and patient outcome by reviewing published papers. Forty-three articles wer e used. Survival difference was combined by use of the DerSimonian-Laird me thod. p53 alteration was either detected as overexpression by the protein s tudies or as mutation by the DNA studies, The incidence of p53 alteration i n DNA studies (381 of 1031; 37%) was lower than that in protein studies (17 25 of 3579; 48%; P < 0,0001, chi(2) test). The incidence of p53 overexpress ion and mutation in adenocarcinoma (36 and 34%) was significantly lower tha n that in squamous cell carcinoma (54 and 52%; P < 0,0001). Combined surviv al differences at 5 years (survival in patients with alteration minus that in patients without alteration) by protein and DNA studies were -9.1% (P = 0.0091) and -22.0% (P = 0.0026), respectively. The negative prognostic effe ct of p53 alteration was highly significant in patients with adenocarcinoma [-21.8% at 5 years (P = 0.0000039) by protein studies and -48.0% (P = 0.00 0031) by DNA studies] but not in patients with squamous cell carcinoma [-15 .6% (P = 0.4241) by protein studies and 2.0% (P = 0.8861) by DNA studies]. In the light of these results, p53 alteration was a significant marker of p oor prognosis in patients with pulmonary adenocarcinoma, Whether p53 altera tion also provides information that can alter treatment decisions should be asked in clinical trials.