p53基因第72位密码子多态性与肺癌临床病理特征及预后关系的Meta分析

p53 Arg72Pro polymorphism and clinicopathologic significance in lung cancer: a meta-analysis

目的系统评价p53基因第72位密码子的多态性与肺癌临床病理特征及预后的关系。方法计算机检索PubMed、中国知网、维普、万方等数据库,收集有关p53基因第72位密码子多态性与肺癌临床病理特征及预后关系的研究。检索时限均从各文献数据库建库时间至2013年12月20日。由2名研究者按照纳入与排除标准独立筛选文献、提取资料和质量评价后,采用RevMan5.0软件进行Meta分析,计算比值比（OR）及其95%可信区间（CI）并行敏感性分析和发表偏倚评估。结果纳入11项研究,共2730例患者。Meta分析结果显示,男性患者中p53基因第72位密码子Arg/Arg或Arg/Pro表型多见,与女性患者相比,差异有统计学意义（OR=1.58,95%CI：1.04~2.40,P=0.03）。p53基因第72位密码子Pro/Pro表型在非鳞癌患者中居多,与鳞癌患者相比,差异有统计学意义（OR=0.69,95%CI：0.49~0.97,P=0.03）。而p53基因第72位密码子多态性与肺癌患者的吸烟史、临床分期、3年生存率无明显相关（P〉0.05）。结论 p53基因第72位密码子的多态性与肺癌患者的预后无明显相关。由于纳入研究的质量和数量有限,降低了本系统评价的证据强度,本系统评价的结论仅供临床研究与实践参考。

Objective To estimate p53 Arg72Pro polymorphism and their relationship with clinicopathological characteristics and prognosis in lung cancer. Methods Such databases as PubMed, CNKI, Wanfang and Weipu were searched from the date of their es- tablishment to December 20th ,2013 to collect the researches about p53 Arg72Pro polymorphism and their relationship with clinicopatho- logical features and prognosis in lung cancer. According to the inclusion and exclusion criteria, two reviewers independently screened lit- eratures, extracted data and assessed the quality of included studies. Then results of meta-analysis were conducted using RevMan 5.0 soft- ware to calculate crude odds ratio（OR） with their 95% confidence interval（95%CI）. Results A total of 11 researches involving 2730 patients were included. The results of meta-analysis suggested that, the distribution frequency of p53 codon72 Arg/Arg or Arg/Pro in male patients with lung cancer was higher than that in female patients with statistic significance（ OR = 1.58, 95%CI： 1.04-2. 40, P = 0. 03）. The distribution frequency of p53 codon72 Pro/Pro genotypes in lung non-squamous cell carcinoma was significantly higher than that in lung squamous cell carcinoma（ OR = 0. 69,95%CI： 0. 49-0. 97, P = 0. 03 ）. p53 Arg72Pro polymorphism was irrelative with smoking history, clinical stages and 3-year survival rate of lung cancer patients. Conclusion p53 Arg72Pro polymorphism is irrelative with prognosis of lung cancer patients. For the quality and quantity limitation of the included studies which decreases the level of evidence, so the conclu- sion of this systematic review only provides some references for clinical research and practice.