The prognostic value of p16 and p53 expression for survival after vulvar cancer: A systematic review and meta-analysis
| Autor: | Christina Louise Rasmussen, Susanne K. Kjaer, Marie Frederiksen, Ditte Maria Bjerno Nielsen, Freja Lærke Sand |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Vulvar Squamous Cell Carcinoma medicine.medical_treatment Disease-Free Survival Targeted therapy 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Cyclin-Dependent Kinase Inhibitor p16 Vulvar Neoplasms business.industry Hazard ratio Obstetrics and Gynecology Vulvar cancer Prognosis medicine.disease Confidence interval 030104 developmental biology 030220 oncology & carcinogenesis Meta-analysis Relative risk Carcinoma Squamous Cell Immunohistochemistry Female Tumor Suppressor Protein p53 business |
| Zdroj: | Gynecologic Oncology. 152:208-217 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2018.10.015 |
| Popis: | The tumor suppressor proteins p16 and p53 have been suggested to have prognostic value in some human papillomavirus (HPV)-associated cancers, however, this has been less well established for vulvar cancer. The aim of this review and meta-analysis was to examine the prognostic value of p16 and p53 expression status on survival after vulvar squamous cell carcinoma (VSCC). We conducted a thorough systematic literature search of multiple databases to identify studies examining survival after histolocally verified VSCC that were tested for p16 and/or p53. A total of 18 eligible studies were included. Using a fixed-effects model we calculated study-specific and pooled hazard ratios (HRs) of 5-year overall survival (OS). In the analyses of OS, we included 475 VSCC cases tested for p16 expression of which 38% were p16 positive. The pooled HRp16 was 0.40 (95% CI: 0.29-0.55). In addition, the majority of results from studies with adjusted analyses on the prognostic value of p16 indicated that p16 expression status could be an independent prognostic marker for OS in women diagnosed with VSCC, and the same pattern was seen for disease specific survival (DSS). We also included 310 VSCC cases tested for p53 expression of which 54% were p53 positive. The pooled HRp53 was 1.81 (95% CI: 1.22-2.68) indicating that p53 positive VSCC have a significantly lower 5-year OS compared to p53 negative. The results in relation to p53 reported from adjusted analyses OS and on DSS and disease free survival were more equivocal. This meta-analysis and review suggests that p53 and especially p16 expression status are of prognostic importance in women diagnosed with VSCC. This may be clinically important in the future design of targeted therapy and when planning the optimal follow-up strategy. Future studies should include the combined use of biomarkers such as p16, p53 and HPV status. |
| Databáze: | OpenAIRE |
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