The prognostic significance of p53 expression in gastric cancer: a meta-analysis.

OBJECTIVE

This meta-analysis was conducted to quantitatively assess the prognostic significance of p53 expression in gastric cancer patients.

METHODS

A systematic literature search was conducted to identify eligible studies in PubMed and Embase. The pooled hazard ratios (HRs) or odds ratios (ORs) with their corresponding 95% confidence intervals (95% CIs) were used to estimate the effect sizes. Moreover, meta-regression analysis and subgroup analysis were carried out.

RESULTS

A total of 34 studies comprising 6,599 patients were subjected to final analysis. Positive/high p53 expression was significantly associated with poorer overall survival (HR 1.56, 95% CI 1.23-1.98) and disease-specific survival (HR 1.52, 95% CI 1.35-1.73). The results also indicated that positive/high p53 expression was significantly associated with gender (OR 1.26, 95% CI 1.09-1.45), Lauren's classification (OR 1.68, 95% CI 1.23-2.29), the depth of invasion (OR 0.68, 95% CI 0.56-0.83), lymph node metastasis (OR 1.56, 95% CI 1.23-1.97), TNM stage (OR 0.57, 95% CI 0.47-0.69), vascular invasion (OR 1.51, 95% CI 1.18-1.92) and lymphatic invasion (OR 1.38, 95% CI 1.11-1.72), but not with Bormann type (OR 1.24, 95% CI 0.91-1.70), grade of differentiation (OR 1.08, 95% CI 0.82-1.44) or distant metastasis (OR 1.37, 95% CI 0.92-2.03).

CONCLUSIONS

This meta-analysis suggests positive/high p53 expression may be a useful biomarker to predict a poorer prognosis for patients with gastric cancer.