Yao Dong, Cai Guo-Hong, Chen Jing, Ling Rui, Wu Sheng-Xi, Li Yong-Ping
Department of Orthopedic Surgery, Shanxi Provincial Corps Hospital of The Chinese People's Armed Police Force 36 Shifan Street, Taiyuan 030006, Shanxi, China ; Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University Xi'an 710032, PR China.
Department of Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, Preclinical School of Medicine, Fourth Military Medical University Xi'an 710032, PR China.
Int J Clin Exp Pathol. 2014 Sep 15;7(10):6725-33. eCollection 2014.
Tumor suppressor gene p53 functions as the guardian of the human genome and mutations in p53 contribute to cancer development. However, studies that investigated the potential of p53 as a prognostic marker in osteosarcoma patients have yielded inconclusive results. Based on recommendation of the Cochrane Collaboration, this meta-analysis was conducted using data from the 17 published studies to evaluate the association of p53 alterations with clinical outcome of osteosarcoma patients. Different databases, including MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Prognostic value of p53 alterations was determined by risk ratio (RR). The data showed that p53-positive immunostaining tended to associate with decreased 2-year survival rates (RR, 1.94; 95% CI, 1.43 to 2.64; p < 0.0001, I(2) = 10%). However, the prediction value of RR was smaller with p53 expression than with p53 mutations. Moreover, patients who received neoadjuvant chemotherapy and surgery tended to have a stronger association between p53-positive staining and 2-year mortality compared to the patients treated with surgery only. However, p53-positive staining was not associated with 3-year (RR, 1.64; 95% CI, 0.84 to 3.20; P = 0.15; I(2) = 56%) and 5-year survival (RR, 1.25; 95% CI, 0.78 to 2.01; P = 0.36; I(2) = 70%). The data from the current study suggest that p53-positive osteosarcoma only predicted a decreased short-term survival rate, but not 3- or 5-year survival.
肿瘤抑制基因p53发挥着人类基因组守护者的作用，p53突变会促进癌症发展。然而，关于p53作为骨肉瘤患者预后标志物潜力的研究结果尚无定论。基于Cochrane协作组织的建议，本荟萃分析利用17项已发表研究的数据进行，以评估p53改变与骨肉瘤患者临床结局的关联。检索了包括MEDLINE、PsycINFO、Scopus、EMBASE和Cochrane对照试验中央注册库（CENTRAL）在内的不同数据库。p53改变的预后价值通过风险比（RR）确定。数据显示，p53阳性免疫染色往往与2年生存率降低相关（RR，1.94；95%CI，1.43至2.64；p<0.0001，I(2)=10%）。然而，与p53突变相比，p53表达的RR预测值较小。此外，与仅接受手术治疗的患者相比，接受新辅助化疗和手术的患者中，p53阳性染色与2年死亡率之间的关联往往更强。然而，p53阳性染色与3年（RR，1.64；95%CI，0.84至3.20；P=0.15；I(2)=56%）和5年生存率（RR，1.25；95%CI，0.78至2.01；P=0.36；I(2)=70%）无关。当前研究的数据表明，p53阳性骨肉瘤仅预测短期生存率降低，而非3年或5年生存率。
