title: p53 expression as a prognostic factor in upper urinary tract urothelial carcinoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To conduct a meta-analysis examining p53 expression as a potential risk factor in upper urinary tract urothelial carcinoma (UUT-UC) and to systematically review the available data.
  
  
  METHODS
  A comprehensive literature review was performed from January 1991 to August 2012, using search engines such as PubMed, EMBASE, Cochrane Library and KoreaMed. All retrieved references were manually reviewed, and two authors independently extracted the data. The quality of case-control and cohort studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) checklists. Heterogeneity among studies was examined using the Q statistics and Higgins' I(2) statistic.
  
  
  RESULTS
  Of 302 abstracts of original research studies, nine case-control trials fit our criteria for inclusion in the analysis. Of the nine articles included, four scored 'low' and five scored 'modest' in the quality assessment performed according to the SIGN checklists. Analysis of the correlation between different factors and p53 expression in UUT-UC showed that pathologic stage (≥pT3 or <pT3) differed significantly between the p53 and non-p53 groups (OR = 2.720, p < 0.001). Statistically significant correlations were also detected between p53 expression and histologic grade (OR = 4.507, p < 0.001) and female gender (OR = 2.724, p < 0.001).
  
  
  CONCLUSIONS
  The results of our meta-analysis suggest that p53 expression in UUT-UC was correlated with advanced pathologic stage, high histologic grade and female gender.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Kang Su
authors.initials: KS
authors.lastname: Cho
authors.forename: Richilda Red
authors.initials: RR
authors.lastname: Diaz
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
authors.forename: Hong Yong
authors.initials: HY
authors.lastname: Choi
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000737:chemistry* / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*; D015854:Up-Regulation; D014571:Urologic Neoplasms / Q000737:chemistry* / Q000473:pathology; D019459:Urothelium / Q000737:chemistry* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53