| Objective: To investigate the correlation between the expression of mutant p53,Bcl-2 and Bax in glioma and WHO classification and prognosis of glioma,provide new ideas for the clinical diagnosis and prognosis of glioma.Methods: Based on the study objectives,Chinese and English search terms were identified and a search strategy was developed.Computer searches of medical databases such as CNKI,CBM,Wipu,Wanfang,Cochrane library,Pub Med,Embase and Web of Science,supplemented by manual searches,the search covers the period from January 2000 to February 2021.2 researchers screened the literature according to the inclusion and exclusion criteria respectively,and the quality of the included literature was evaluated using the NOS literature quality evaluation form.The data was extracted and the effect sizes were combined using Revman 5.3 software and sensitivity analysis was carried out using the single item-by-item elimination method.Funnel plots,Egger’s method and Begg’s method were produced to analyse the inclusion literature for publication bias.Results: 1.A total of 63 studies involving the correlation between mutant p53,Bcl-2 and Bax expression and WHO classification of glioma were searched for,including 34 on mutant p53,28 on Bcl-2 and 12 on Bax,with 2334,1807 and 816 cases included,respectively;The number of studies correlating mutant p53,Bcl-2 and Bax expression with overall survival in glioma was 6,2 and 1,respectively,and the number of cases included was 530,194 and 94,respectively.2.Correlation of mutant p53 expression with WHO classification and overall survival in glioma: The mutant p53 protein expression rate was significantly higher in the high-grade glioma group than in the low-grade glioma group(OR 2.77,95% CI 2.31-3.31,P <0.05);The rate of mutant p53 protein positivity was higher in the glioma group than in the control group(non-glioma brain tissue)(OR 19.54,95% CI 11.91-32.04,P < 0.05);The overall survival rates of patients with mutant p53 positive glioma at 1 year(RR 0.79,95%CI 0.69-0.89,P < 0.05),2 years(RR 0.76,95%CI 0.65,0.88,P < 0.05)and 5 years(RR 0.55,95%CI 0.39,0.77,P < 0.05)were significantly lower than those of patients with mutant p53 negative glioma,While the 3-year overall survival rate(RR 0.91,95% CI 0.72,1.16,P > 0.05)between the mutant p53-positive and negative groups was not statistically different.3.Correlation of Bcl-2 expression with WHO classification and overall survival of glioma: The rate of Bcl-2 protein positivity was higher in the high-grade glioma group than in the low-grade glioma group(OR 2.68,95% CI 1.40-5.12,P < 0.05);The rate of Bcl-2 protein positivity was higher in the glioma group than in the control group(OR 33.11,95% CI 17.55-62.44,P < 0.05);No statistical difference in 3-year overall survival(RR 0.42,95% CI 0.09,1.90,P > 0.05)between the Bcl-2 protein positive expression group and the negative group in patients with glioma.4.Correlation of Bax expression with WHO classification and overall survival period in glioma: The rate of Bax protein positivity was lower in the high-grade glioma group than in the low-grade glioma group(OR 0.27,95% CI 0.10-0.72,P < 0.05);The rate of Bax protein positivity was lower in the glioma group than in the control group(OR 0.28,95% CI 0.12-0.62,P < 0.05).5.The single exclusion method analysis showed no significant change in the results of the meta-analysis before and after the exclusion of each study,suggesting stable results;The publication bias analysis showed that the distribution of each study was symmetrical in the funnel plot,Egger’s test and Begg’s test P values were greater than 0.05,it suggested that there was no obvious publication bias in the included literatures.Conclusions: 1.mutant p53,Bcl-2,and Bax expression all correlated with WHO classification of glioma,the mutant p53 and Bcl-2 positivity rates were higher in patients with high-grade glioma than low-grade glioma,while the Bax positivity rate was lower in the high-grade glioma group than in the low-grade glioma group.It is suggested that the expressions of mutant p53,Bcl-2 and Bax have certain predictive value in WHO grading of glioma patients.2.The expression of mutant p53 and Bcl-2 in glioma tissue was significantly higher than that in normal brain tissue,while the expression of Bax was significantly lower than that in normal brain tissue.It is suggested that the expression of mutant p53,Bcl-2 and Bax has potential value in the diagnosis of glioma.3.Glioma tissue mutant p53 expression is associated with shorter overall survival.It is helpful to predict the prognosis of patients. |
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