Fu Hai-Liang, Shao Lin, Wang Qiang, Jia Tao, Li Ming, Yang Da-Ping
Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China,
Tumour Biol. 2013 Dec;34(6):3817-21. doi: 10.1007/s13277-013-0966-x. Epub 2013 Sep 7.
Osteosarcoma is the most common malignant bone tumor, and the prognosis of patients with osteosarcoma is still unsatisfactory with low survival rates. There are many studies assessing the prognostic role of upregulated p53 in patients presenting osteosarcoma, and there is no consistent finding. To summarize the existing evidence about whether the presence of upregulated p53 was a biomarker of survival in patients with osteosarcoma, we performed a systematic review and meta-analysis of relevant publications. We assessed the effect of upregulated p53 on the 3-year overall survival and the 3-year disease-free survival by calculating the pooled odds ratio (OR) with corresponding 95% confidence interval (95%CI). Fifteen studies with a total of 609 patients with osteosarcoma were finally included into the systematic review and meta-analysis. Compared with osteosarcoma patients with low or undetectable p53, patients with upregulated p53 were obviously associated with decreased 3-year overall survival (OR = 0.29, 95 %CI 0.19-0.43, P < 0.001). In addition, patients with upregulated p53 were obviously associated with decreased 3-year disease-free survival (OR = 0.06, 95 %CI 0.02-0.23, P < 0.001). The results from the systematic review and meta-analysis highlight that p53 is an effective biomarker of survival in patients with osteosarcoma. In addition, more studies with a large sample size are needed to identify the effect of p53 expression in osteosarcoma patients.
骨肉瘤是最常见的恶性骨肿瘤，骨肉瘤患者的预后仍然不尽人意，生存率较低。有许多研究评估了p53上调在骨肉瘤患者中的预后作用，但没有一致的发现。为了总结关于p53上调是否是骨肉瘤患者生存生物标志物的现有证据，我们对相关出版物进行了系统评价和荟萃分析。我们通过计算合并比值比（OR）及相应的95%置信区间（95%CI）来评估p53上调对3年总生存率和3年无病生存率的影响。最终，共有609例骨肉瘤患者的15项研究被纳入系统评价和荟萃分析。与p53低表达或检测不到的骨肉瘤患者相比，p53上调的患者3年总生存率明显降低（OR = 0.29，95%CI 0.19 - 0.43，P < 0.001）。此外，p53上调的患者3年无病生存率明显降低（OR = 0.06，95%CI 0.02 - 0.23，P < 0.001）。系统评价和荟萃分析的结果表明，p53是骨肉瘤患者生存的有效生物标志物。此外，还需要更多大样本量的研究来确定p53表达在骨肉瘤患者中的作用。
