食管鳞癌患者TP53表达与预后相关性的荟萃分析

Correlation between TP53 expression and prognosis of ESCC: a Meta-analysis

目的探讨TP53蛋白阳性表达在食管鳞癌预后评估中的意义。方法在中文及外文检索工具中系统检索有关TP53蛋白表达与食管鳞癌临床病理特点及预后判断的文献,检索时限为2008年2月-2018年8月。由2名研究员独立筛选文献、提取资料并评估纳入研究的偏倚风险后,采用Review Manager 5.3软件对数据进行荟萃分析。结果共入选24篇病例-对照研究及队列研究的文献,累计病例2 191例。荟萃分析结果显示,中、低分化食管鳞癌TP53基因蛋白阳性表达率明显高于高分化鳞癌,差异有统计学意义(OR=1.80,P=0.04)。浸润深度中T3+T4的TP53蛋白阳性表达率显著高于T1+T2,差异有统计学意义(OR=2.61,P=0.000 1)。有淋巴结转移病例癌组织中TP53蛋白阳性表达率明显高于无淋巴结转移者,差异有统计学意义(OR=2.27,P=0.000 2)。结论 TP53阳性表达与食管鳞癌临床恶性表型相关,可能是患者不良预后的一个生物标志物,有利于病情评估以及治疗决策的制定。

Objective To estimate the relationship between TP53 expression and prognosis of esophageal squamous cell carcinoma(ESCC). Methods Documents published on foreign language database and Chinese database were searched for study about the relationship between TP53 and clinicopathological characteristics and prognosis of ESCC from February 2008 to August 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then Meta-analysis was performed using RevMan 5.3 software. Results A Total of 2 191 patients from 24 studies were included. The results of meta-analysis showed that the positive expression rate of TP53 in middle and poorly differentiated carcinoma was significantly higher than that in well-differentiated carcinoma, the difference was statistically significant(OR=1.80, P=0.04). The positive expression rate of TP53 in T3+T4 was significantly higher than that in T1+T2;The deeper the degree of infiltration, the higher the positive expression rate of TP53 in cancer tissue, the difference was statistically significant(OR=2.61;P=0.000 1). The positive expression rate of TP53 in cancerous tissues with positive lymph node metastasis was significantly higher than that in patients with negative lymph node metastasis, the difference was statistically significant(OR=2.27, P=0.000 2). Conclusion Meta-analysis showed that the positive expression rate of TP53 was related to the clinical malignant phenotype of ESCC,and TP53 possibly could be used as a biomarker of poor prognosis in patients with esophageal cancer, which is conducive to the treatment of esophageal cancer.