TP53 mutation predicts the poor prognosis of non-Hodgkin lymphomas: Evidence from a meta-analysis

PLoS One. 2017 Apr 3;12(4):e0174809. doi: 10.1371/journal.pone.0174809. eCollection 2017.

Abstract

Non-Hodgkin lymphoma (NHL) is a group of malignant hematologic disorders with high heterogeneity. The diagnosis, clinical manifestations, classification, and prognosis of this condition differ among numerous NHL subgroups. The prognostic significance of the mutation of TP53, a tumor suppressor gene involved in cell cycle regulation, should be confirmed in NHL. In this study, our searching strategy and inclusion criteria were implemented, and the pooled hazard ratios (HRs) of the included studies were calculated directly or indirectly. A total of 1,851 patients were enrolled in 22 studies. A meta-analysis was then performed using STATA version 12.0 to confirm the correlation between the status of TP53 mutation and the survival time of patients with NHL. Statistical heterogeneity was assessed with a chi-square-based Q statistical test and Inconsistency index (I2) statistic. Sensitivity analysis and publication bias were also evaluated. A total of 22 studies were included in our meta-analysis. The pooled HR of the overall survival from 20 studies was 2.30 (95% CI: 1.92-2.76, p = 0.001) with heterogeneity (I2 30.2% p = 0.099). The pooled HR of the progression free survival provided in 5 articles was 2.28 (95% CI: 1.78-2.93, p = 0.001) with heterogeneity (I2 39.8% p = 0.156). No publication bias was found among the included studies, and sensitivity analysis suggested that the combined HRs were stable after any of the studies was excluded from our meta-analysis. This study identified the prognostic significance of TP53 mutation that varied in different NHL subgroups. The group with a mutated TP53 was significantly associated with poor prognosis in patients with NHL. This parameter is a valuable basis for accurate individual therapeutic regimens.

Publication types

  • Meta-Analysis

MeSH terms

  • Disease-Free Survival
  • Humans
  • Lymphoma, Non-Hodgkin / diagnosis*
  • Lymphoma, Non-Hodgkin / genetics*
  • Lymphoma, Non-Hodgkin / therapy
  • Mutation*
  • Prognosis
  • Tumor Suppressor Protein p53 / genetics*

Substances

  • TP53 protein, human
  • Tumor Suppressor Protein p53

Grants and funding

This work was funded by the National Natural Science Foundation of China (81400162, 81570174 to PX), the Natural Science Foundation of Jiangsu Province (BK20140100 to PX), the Science and Technology Development Program of Nanjing (201402066 to BC), the Medical Science and Technology Development Program of Nanjing (Ykk14069 to BC) and the Technique Development Foundation of Nan Jing (Outstanding Youth Foundation, JQX15004 to PX). These funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.