Department of General Surgery Second Ward, The First People's Hospital of Qinzhou, Qinzhou, Guangxi Zhuang Autonomous Region 535000, People's Republic of China.
Department of Intensive Care Unit, The First People's Hospital of Qinzhou, Qinzhou, Guangxi Zhuang Autonomous Region 535000, People's Republic of China.
Gene. 2020 Apr 15;734:144351. doi: 10.1016/j.gene.2020.144351. Epub 2020 Jan 23.
P27 is a cyclin-dependent kinase inhibitor that has gained importance as a biomarker in human malignant tumors. However, the potential role of P27 in hepatocellular carcinoma remains unclear. The aim of this meta-analysis was to explore whether P27 acts as prognostic and clinicopathological roles in hepatocellular carcinoma patients.
METHODS/MATERIALS: An electronic search based on three databases, PubMed, Embase, and Web of Science, was performed to select a sufficient number of studies. Pooled hazard ratio (HR) and odds ratio (OR) were used as estimates to investigate the association among P27 expression, prognosis and clinicopathological features.
In total, we identified 18 studies with 1774 hepatocellular carcinoma patients. The result derived from four studies revealed a significant positive association between lower P27 levels and shorter overall survival (HR = 0.550, 95% CI: 0.464-0.652, P < 0001) and disease-free survival (HR = 0.420, 95% CI: 0.308-0.571, P < 0.0001). Analyses of the clinicopathological features and P27 expression also showed that a positive rate of P27 was significantly lower in a larger sized tumor (OR = 0.538, 95% CI: 0.315-0.919, P = 0.023). The results also revealed that lower P27 levels were correlated with poorer differentiation (0.416, 95% CI: 0.178-0.971, P = 0.043). Additionally, the pooled OR of 0.389 also presented a significant correlation between P27 underexpression and the metastasis of HCCs (95% CI: 0.155-0.975, P = 0.044).
This analysis suggests a strong association among P27 underexpression, poorer prognosis and aggressive progression of hepatocellular carcinoma in patients. P27 may be a tumor suppressor for predicting the progression and survival outcome in patients with hepatocellular carcinomas.
P27 是一种细胞周期蛋白依赖性激酶抑制剂，作为人类恶性肿瘤的生物标志物受到重视。然而，P27 在肝细胞癌中的潜在作用尚不清楚。本荟萃分析的目的是探讨 P27 是否在肝细胞癌患者中发挥预后和临床病理作用。
方法/材料：基于三个数据库 PubMed、Embase 和 Web of Science 进行电子检索，以选择足够数量的研究。使用合并的风险比 (HR) 和优势比 (OR) 作为估计值，以研究 P27 表达、预后和临床病理特征之间的关联。
总共确定了 18 项研究，涉及 1774 例肝细胞癌患者。四项研究的结果表明，P27 水平较低与总生存期 (HR=0.550，95%CI：0.464-0.652，P<0.0001) 和无病生存期 (HR=0.420，95%CI：0.308-0.571，P<0.0001) 缩短有显著正相关。对临床病理特征和 P27 表达的分析也表明，肿瘤较大时 P27 的阳性率显著降低 (OR=0.538，95%CI：0.315-0.919，P=0.023)。结果还表明，P27 水平较低与分化较差相关 (0.416，95%CI：0.178-0.971，P=0.043)。此外，0.389 的合并 OR 也显示 P27 低表达与 HCC 转移之间存在显著相关性 (95%CI：0.155-0.975，P=0.044)。
该分析表明 P27 低表达、预后不良和肝细胞癌侵袭性进展之间存在很强的关联。P27 可能是预测肝细胞癌患者进展和生存结局的肿瘤抑制因子。
