Expression Of P53 Protein In Patients With Breast Cancer And Its Clinical Significance

Objective:The purpose of this study is to explore the correlation between expression of p53 protein and clinicopathological features in patients with breast cancer. A meta-analysis was conducted to assess whether the expression of p53 protein could predict the efficacy of neo-adjuvant chemotherapy (NAC).Methods:The clinical pathological data of 214 cases of breast cancer patients, diagnosed and treated in our department, were collected, and retrospective analysis of p53 protein expression and its correlation with clinical pathological characteristics. Using the Spearman correlation index to express their relationship. A systematic review was conducted in the databases listed below and the publication date restricted before January 2015:PubMed, Embase. CNKI、VIP、CBM and WangFang databases. Literatures was screened and data was collected according to inclusion criteria and data collection form respectively by two investigator independently. Meta-analysis was conducted by a random or fixed effect model according to whether the heterogeneity existed among eligible studies. Statistical analyses were performed by virtue of software SPSS version 17.0 and STATA SE12.0. All tests were two-sided with a significance of P<0.05.Results:The positive rate of p53 protein was 52.3% in breast cancer tissue. The expression of p53 was not correlated with age and tumor size (P > 0.05), it was positive correlation with lymph-node metastasis, histological classification, clinical stage and molecular subtype (r=0.396. 0.309.0.197.0.167, P=0.000.0.000.0.004.0.014), and also have negative correlation with the expression rate of ER and PR (r=-0.561.-0.315, P=0.000.0.000), positive correlation with status of HER-2 and Ki-67 expression (r=0.374.0.153, P=0.000.0.026). In the group of TNBC and the group of non-TNBC, the difference was statistically significant of expression of p53 (P<0.05). Twenty-two eligible studies enrolling 1846 patients were appropriate for pooled analysis. Meta-analysis showed that the difference of clinical response to NAC between p53 positive groups and p53 negative group was statistical differences [OR=0.64,95%CI (0.42-0.98), P=0.041]. In subgroup analysis of p53 positive with a cutoff of 10%, p53 over expression was associated with a worse response to NAC in patients with breast cancer [OR=0.52,95%CI (0.31-0.88), P=0.015].Conclusions:p53 protein has closely related with the clinical characteristics and pathological features in breast cancer patients, its positive detection indicates a worse clinical response to NAC. The detection of p53 can be serve as a reference index in individual treatment and response to NAC.