- 作者：Jiangbo Liu ; Qingyong Ma ; Min Zhang ; Xinshuai Wang ; Dong Zhang ; Wei Li ; Fengfei Wang ; Erxi Wu
- 关键词：Systematic review ; Meta-analysis ; TP53 ; Hepatocellular carcinoma ; Tumour marker
- 刊名：European Journal of Cancer
- 出版年：2012
- 出版时间：October, 2012
- 年：2012
- 卷：48
- 期：15
- 页码：2328-2338
- 全文大小：858 K
Background
The prognostic significance of p53 aberration in hepatocellular carcinoma (HCC) remains inconclusive. This systematic review and meta-analysis aimed to provide comprehensive evidence on the association of p53 alterations with recurrence-free survival (RFS) and overall survival (OS) in HCC patients.Methods
Systematic literature searches were conducted until July 2010. Meta-analysis was performed to estimate prognostic effects of p53 alterations on patient outcomes in HCC. Sensitivity and subgroup analyses were also conducted in the meta-analysis.
Results
Thirty-seven studies (7 tumour p53 mutation, 23 tumour p53 expression and 7 serum anti-p53 antibodies) were included in the systematic review and meta-analysis. The average percentages of p53 mutation, p53 expression upregulation and anti-p53 antibody level elevation in HCC patients were 31.5 % , 35.0 % and 23.8 % , respectively. Tumour p53 alterations were associated significantly with poor patient outcomes in HCC: the summary hazard ratio (HR) of mutant p53 versus wild type p53 phenotype was 2.58 [95 % confidence interval (CI): 1.96-3.41] for OS and 3.19 [95 % CI: 2.21-4.60] for RFS, respectively; and the summary HR of upregulated p53 expression versus low/undetectable p53 expression was 1.68 [95 % CI: 1.49-1.90] for OS and 1.89 [95 % CI: 1.34-2.66] for RFS, respectively. However, elevated serum anti-p53 antibody was only associated with poor OS in HCC group with a high proportion of (?50 % ) of hepatitis C virus (HCV) infection [HR: 1.92; 95 % CI: 1.30-2.85]. Moreover, sensitivity analyses showed that the results of meta-analyses were not altered.
Conclusion
HCC patients with p53 mutation and upregulated expression in tumour tissue have a shorter OS and RFS than patients with wild type p53 and low/undetectable p53 expression. However, the prognostic value of serum anti-p53 antibody is required to be further examined.