Tammemagi M C, McLaughlin J R, Bull S B
Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Michigan 48202-3450, USA.
Cancer Epidemiol Biomarkers Prev. 1999 Jul;8(7):625-34.
p53 alterations are the most common genetic lesions observed in lung cancers. Because of the limited size of individual studies, the distributions of p53 alterations by clinicopathological features have not been well characterized. Here, we present meta-analyses describing the occurrence of p53 alterations by patient/tumor characteristics in resected lung cancer. The association between p53 alterations (gene and/or protein) and a variety of variables were evaluated by calculating pooled odds ratios (ORs) and confidence intervals (CIs). p53 alterations were detected in 46.8% of 4684 non-small cell lung cancers. p53 alterations occurred more frequently in the more strongly smoking-associated histotypes: squamous cell (51.2%) and large cell (53.7%) carcinomas versus adenocarcinomas [38.8%; OR (squamous versus adenocarcinoma) = 1.81, 95% CI = 1.55-2.11]. p53 alterations were found to be associated with T1-4, N0-3, stage I-III, differentiation, and sex: OR (T3 versus T1) = 1.62 (95% CI = 0.99-2.65), OR (N1-3 versus N0) = 1.65 (95% CI = 1.27-2.15), OR (stage III versus stage I) = 1.98 (95% CI = 1.35-2.89), OR (poorly and moderately versus well-differentiated) = 3.04 (95% CI = 1.56-5.94), and OR (male versus female) = 1.39 (95% CI = 1.10-1.75). No strong associations between p53 and ras or aneuploidy were observed. Lung cancer studies of p53 and smoking need to consider the effect of histotype, and prognostic studies of p53 should adjust for the effects of T and N or stage and histotype. The apparent association between p53 and sex may be confounded by histotype and must be evaluated by multivariate studies.
p53改变是肺癌中最常见的基因损伤。由于个别研究规模有限，p53改变按临床病理特征的分布尚未得到很好的描述。在此，我们进行荟萃分析，描述在切除的肺癌中按患者/肿瘤特征出现的p53改变情况。通过计算合并比值比（OR）和置信区间（CI）来评估p53改变（基因和/或蛋白）与各种变量之间的关联。在4684例非小细胞肺癌中，46.8%检测到p53改变。p53改变在与吸烟关联更强的组织学类型中更频繁发生：鳞状细胞癌（51.2%）和大细胞癌（53.7%），而腺癌为38.8%；OR（鳞状细胞癌与腺癌相比）=1.81，95%CI=1.55 - 2.11。发现p53改变与T1 - 4、N0 - 3、I - III期、分化程度和性别有关：OR（T3与T1相比）=1.62（95%CI=0.99 - 2.65），OR（N1 - 3与N0相比）=1.65（95%CI=1.27 - 2.15），OR（III期与I期相比）=1.98（95%CI=1.35 - 2.89），OR（低分化和中分化与高分化相比）=3.04（95%CI=1.56 - 5.94），以及OR（男性与女性相比）=1.39（95%CI=1.10 - 1.75）。未观察到p53与ras或非整倍体之间有强关联。肺癌中关于p53和吸烟的研究需要考虑组织学类型的影响，p53的预后研究应调整T和N或分期及组织学类型的影响。p53与性别之间明显的关联可能受组织学类型混淆，必须通过多变量研究进行评估。
