Prognostic and clinicopathological value of p53 expression in renal cell carcinoma: a meta-analysis

Abstract

BackgroundThe prognostic value of p53 expression in renal cell carcinoma (RCC) had been investigated in previous studies; however, the results remain inconsistent. This study was performed to investigate the prognostic and clinicopathological significance of p53 protein expression in RCC.Materials and MethodsLiterature was identified from PubMed, Embase, Web of Science, and Cochrane database, which investigated the relationships between p53 expression and outcomes. Hazard ratios (HRs) for survival outcomes and odds ratios (ORs) for clinical parameters associated with p53 were extracted from eligible studies. Heterogeneity was assessed using the I2 value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg's funnel plots and Egger's regression test.ResultsA total of 2,013 patients from 22 studies were included in the meta-analysis. The results showed that p53 positive expression is associated with poor overall survival (OS) (HR = 2.17, 95% confidence [CI]: 1.51–3.13) and cancer-specific survival (CSS) (HR = 1.59, 95% CI: 1.19–2.12) in RCC. In addition, p53 positive expression was closely correlated with TNM stage (III/IV vs. I/II: OR = 2.51, 95% CI: 1.05–6.00), Fuhrman grade (III/IV vs. I/II: OR = 1.80, 95% CI: 1.24–2.63), and distant metastasis (M1 vs. M0: OR = 1.70, 95% CI: 1.16–2.49), but not related to lymph node involvement (N1 vs. N0: OR = 1.32, 95% CI: 0.80–2.18), primary tumor stage (pT3/pT4 vs. pT1/pT2: OR = 1.16, 95% CI: 0.88–1.53), and sex (n = 2, male vs. female, OR = 1.09, 95% CI: 0.70–1.68).ConclusionsThis study suggests that p53 positive expression is correlated with poor prognosis and advanced clinicopathological features in patients with RCC, which indicates that p53 is a potentially effective therapeutic target.

Histone deacetylase inhibitors dysregulate DNA repair proteins and antagonize metastasis-associated processes

“…In general, p53 wild-type expression in Renca cells would correspond to the majority of cells derived from common renal cancers. TP53 mutation rates in this disease are exceptionally low in comparison to other cancer types, with 2.5% for renal papillary-cell carcinoma and 2.4% for renal clear-cell carcinoma (Wang et al 2017).…”

Impact of Preanalytical Factors on the Measurement of Tumor Tissue Biomarkers Using Immunohistochemistry

“…For example, a 40% decline in p53 H-score after a 3-hr DTF could result in a lower percentage of p53 immunopositive cells than the >10% threshold specified for use of p53 as a prognostic biomarker of renal cell carcinoma. 61,62 PAX8 has shown promise in distinguishing renal tumors of primary and metastatic origin alone 63 or in combination with PAX2, 41 and H-scores for PAX8 and PAX2 observed during the DTF time course lie on the spectrum of those identified for differentiating primary and metastatic tumors. PAX8 is also a promising prognostic marker for ovarian cancer with a threshold of 3+ staining in ≥51% cells.…”

Value of Ferritin Heavy Chain (FTH1) Expression in Diagnosis and Prognosis of Renal Cell Carcinoma

“…Increased expression of long noncoding RNA GIHCG is positively correlated with advanced TNM stages, Fuhrman grades, and poor prognosis [31]. In a meta-analysis of 2013 patients, including 22 studies, positive expression of P53 was associated with poor prognosis and advanced clinicopathological features in RCC patients [32]. The nuclear translocation of CXCR4 plays an important role in RCC metastasis and is associated with poor prognosis [33].…”