Meta-analyses of p53 tumor suppressor gene alterations and clinicopathological features in resected lung cancers

p53 alterations are the most common genetic lesions observed in lung cancer s. Because of the limited size of individual studies, the distributions of p53 alterations by clinicopathological features have not been well characte rized. Here, we present meta-analyses describing the occurrence of p53 alte rations by patient/tumor characteristics in resected lung cancer. The assoc iation between p53 alterations (gene and/or protein) and a variety of varia bles were evaluated by calculating pooled odds ratios (ORs) and confidence intervals (CIs), p53 alterations were detected in 46.8% of 4684 non-small c ell lung cancers. p53 alterations occurred more frequently in the more stro ngly smoking-associated histotypes: squamous cell (51.2%) and large cell (5 3.7%) carcinomas versus adenocarcinomas [38.8%; OR (squamous versus adenoca rcinoma) = 1.81, 95% CI = 1.55-2.11], p53 alterations were found to be asso ciated with T1-4, N0-3, stage I-III, differentiation, and sex: OR (T-3 vers us T-1) = 1.62 (95% CI = 0.99-2.65), OR (N1-3 versus N-0) = 1.65 (95% CI = 1.27-2.15), OR (stage III versus stage I) 1.98 (95% CI = 1.35-2.89), OR (po orly and moderately versus well-differentiated) = 3.04 (95% CI = 1.56-5.93) , and OR (male versus female) = 1.39 (95% CI = 1.10-1.75), No strong associ ations between p53 and ras or aneuploidy mere observed. Lung cancer studies of p53 and smoking need to consider the effect of histotype, and prognosti c studies of p53 should adjust for the effects of T and N or stage and hist otype. The apparent association between p53 and sex may be confounded by hi stotype and must be evaluated by multivariate studies.