title: Prognostic significance of p53 expression in patients with esophageal cancer: a meta-analysis.
abstract: The prognostic value of p53 protein expression in esophageal cancer has been evaluated, but the results remain inconclusive and no consensus has yet been achieved. This meta-analysis was conducted to quantitatively assess the prognostic significance of p53 expression in esophageal cancer.
  
  
  
  Publications that assessed the clinical or prognostic significance of p53 expression in esophageal cancer and were published before July 1, 2015 were identified by searching the PubMed and EMBASE databases. A meta-analysis was performed to clarify the association between p53 expression and the clinical outcomes.
  
  
  
  A total of 36 publications met the criteria and included 4577 cases. Analysis of these data showed that p53 expression in esophageal cancer was significantly associated with poorer 5-year survival (RR = 1.30, 95 % CI: 1.11-1.51, P = 0.0008). Subgroup analyses according to histological type, continent of the patients, and cut-off value revealed the similar results. The results also indicated that p53 expression was highly associated with advanced TNM stages (I/II vs. III/IV, OR = 0.74, 95 % CI: 0.55-0.99, P = 0.04), lymph node metastasis (OR = 0.77, 95 % CI: 0.66-0.90, P = 0.001), and distant metastasis (OR = 0.46, 95 % CI: 0.26-0.80, P = 0.006). However, p53 expression in the included studies was not significantly associated with tumor size (≤ 5 cm vs. > 5 cm, OR = 1.13, 95 % CI: 0.92-1.40, P = 0.24), tumor location (upper + middle vs. lower, OR = 0.91, 95 % CI: 0.70-1.17, P = 0.45), grade of differentiation (well + moderate vs. poor, OR = 1.10, 95 % CI: 0.90-1.34, P = 0.35), and the depth of invasion (T1/T2 vs. T3/T4, OR = 0.86, 95 % CI: 0.71-1.03, P = 0.09).
  
  
  
  This meta-analysis showed that p53 expression may be a useful biomarker for predicting poorer prognosis in patients with esophageal cancer.
authors.affiliation: Department of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
authors.forename: Lianghai
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Immunology, Shihezi University School of Medicine, Shihezi, Xinjiang, China. houjun229@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Hou
authors.affiliation: Department of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China. lifeng7855@126.com.|Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. lifeng7855@126.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
mesh_terms: D004938:Esophageal Neoplasms / Q000378:metabolism* / Q000473:pathology*; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: Esophageal cancer; Meta-analysis; Prognosis; p53