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Meta-Analyses of p53 Tumor Suppressor Gene Alterations and Clinicopathological Features in Resected Lung Cancers¹

Josephine Ford Cancer Center, Henry Ford Health System, Detroit, Michigan 48202-3450 [M. C. T.]; and Department of Public Health Sciences [J. R. M.] and Samuel Lunenfeld Institute of Mount Sinai Hospital, Division of Clinical Epidemiology and Department of Public Health Sciences [S. B. B.], University of Toronto, Toronto, Ontario, Canada M5S 1A8

p53 alterations are the most common genetic lesions observed in lung cancers. Because of the limited size of individual studies, the distributions of p53 alterations by clinicopathological features have not been well characterized. Here, we present meta-analyses describing the occurrence of p53 alterations by patient/tumor characteristics in resected lung cancer. The association between p53 alterations (gene and/or protein) and a variety of variables were evaluated by calculating pooled odds ratios (ORs) and confidence intervals (CIs). p53 alterations were detected in 46.8% of 4684 non-small cell lung cancers. p53 alterations occurred more frequently in the more strongly smoking-associated histotypes: squamous cell (51.2%) and large cell (53.7%) carcinomas versus adenocarcinomas [38.8%; OR (squamous versus adenocarcinoma) = 1.81, 95% CI = 1.55–2.11]. p53 alterations were found to be associated with T_1–4, N_0–3, stage I–III, differentiation, and sex: OR (T₃ versus T₁) = 1.62 (95% CI = 0.99–2.65), OR (N_1–3 versus N₀) = 1.65 (95% CI = 1.27–2.15), OR (stage III versus stage I) = 1.98 (95% CI = 1.35–2.89), OR (poorly and moderately versus well-differentiated) = 3.04 (95% CI = 1.56–5.94), and OR (male versus female) = 1.39 (95% CI = 1.10–1.75). No strong associations between p53 and ras or aneuploidy were observed. Lung cancer studies of p53 and smoking need to consider the effect of histotype, and prognostic studies of p53 should adjust for the effects of T and N or stage and histotype. The apparent association between p53 and sex may be confounded by histotype and must be evaluated by multivariate studies.

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