Gu Jincui, Zhou Yanbin, Huang Lixia, Ou Weijun, Wu Jian, Li Shaoli, Xu Junwen, Feng Jinlun, Liu Baomo
Department of Respiratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China.
Center of Organ Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China.
Mol Clin Oncol. 2016 Dec;5(6):705-713. doi: 10.3892/mco.2016.1057. Epub 2016 Oct 21.
A number of studies have examined the association between tumor protein 53 (TP53) mutations and the clinical outcome in patients with non-small-cell lung cancer (NSCLC), although these have yielded conflicting results. In the present study, electronic databases updated to September 2015 were searched to find relevant studies. A meta-analysis was performed on the eligible studies, which quantitatively evaluated the association between the TP53 mutations and the survival of patients with NSCLC. Subgroup and sensitivity analyses were performed. A total of 19 studies that involved a total of 6,084 patients with NSCLC were included. When the TP53 mutation group (n=1,406) was compared with the wild-type group (lacking TP53 mutations; n=1,965), the wild-type group was associated with a significantly higher overall survival rate [hazard ratio (HR), 1.26; 95% confidence interval (CI) 1.12-1.41, P<0.0001]. Significant benefits of overall survival in the wild-type group were found in the subgroup involving patients with NSCLC in the early stages, including the I/II phases (HR, 1.93, 95% CI, 1.17-3.19, P=0.01; heterogeneity, I=0.0%, P=0.976) and patients with adenocarcinoma (HR, 3.06; 95% CI, 1.66-5.62, P<0.0001; heterogeneity: I=0.0%, P=0.976). This meta-analysis has indicated that TP53 gene alteration may be an indicator of a poor prognosis in patients with NSCLC. Furthermore, the results also suggested that the role of TP53 mutations may differ according to different pathological types and clinical stages. The presence of these mutations may define a subset of patients with NSCLC appropriate for investigational therapeutic strategies.
多项研究探讨了肿瘤蛋白53(TP53)突变与非小细胞肺癌(NSCLC)患者临床结局之间的关联,尽管这些研究结果相互矛盾。在本研究中,检索了截至2015年9月更新的电子数据库以查找相关研究。对符合条件的研究进行荟萃分析,定量评估TP53突变与NSCLC患者生存率之间的关联。进行了亚组分析和敏感性分析。共纳入19项研究,涉及6084例NSCLC患者。将TP53突变组(n = 1406)与野生型组(无TP53突变;n = 1965)进行比较时,野生型组的总生存率显著更高[风险比(HR)为1.26;95%置信区间(CI)为1.12 - 1.41,P < 0.0001]。在早期NSCLC患者亚组中,包括I/II期(HR为1.93,95% CI为1.17 - 3.19,P = 0.01;异质性,I = 0.0%,P = 0.976)和腺癌患者(HR为3.06;95% CI为1.66 - 5.62,P < 0.0001;异质性:I = 0.0%,P = 0.976)中,发现野生型组在总生存方面有显著益处。这项荟萃分析表明,TP53基因改变可能是NSCLC患者预后不良的一个指标。此外,结果还表明,TP53突变的作用可能因不同的病理类型和临床分期而异。这些突变的存在可能确定了一部分适合研究性治疗策略的NSCLC患者。