The Prognostic Significance Of P53 Expression In Gastric Cancer: A Meta-Analysis

Objective:Positive/high p53 expression is implicated in tumor development and progression. Numerous studies investigated the association between p53 expression and the prognosis of gastric cancer patients but yielded conflicting findings. We thus performed a meta-analysis to quantitatively assess the prognostic significance of p53 expression in gastric cancer patients.Methods:A systematic literature search was conducted to find eligible studies in Pub Med and Embase up to February 25, 2014. 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 according to ethnicity, HR extraction, survival analysis and quality score.Results:A total of 34 studies comprising 6599 patients were subjected to final analysis. Positive/high p53 expression was significantly associated with poorer overall survival(OS)(HR=1.56, 95%CI: 1.23–1.98) and disease specific survival(DSS)(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.