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Prognostic Value of Overexpressed p16INK4a in Vulvar Cancer: A Meta-Analysis.

Cao H, Wang S, Zhang Z, Lou J - PLoS ONE (2016)

Bottom Line: Strict inclusion and exclusion criteria were followed.A total of 17 studies with 2309 patients were included.The p16INK4a overexpression was found to correlate significantly with the lower International Federation of Gynecology and Obstetrics stage (I+II vs III+IV; OR = 0.60, 95%CI: 0.41-0.86, P = 0.006), negative lymph node metastasis(negative vs positive; OR = 0.61, 95%CI: 0.39-0.95, P = 0.029), patient's age <55 (OR = 0.54, 95%CI: 0.31-0.96, P = 0.034), human papillomavirus-positive status (OR = 0.01, 95%CI: 0.00-0.11, P<0.001), and higher overall survival (RR = 0.53, 95%CI = 0.35-0.80, P = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu City, Sichuan Province, China.

ABSTRACT

Objective: This study aimed to examine the prognostic value of overexpressed p16INK4a in vulvar cancer. Although the tumor suppressor p16INK4a has been shown to be of prognostic value in a wide variety of cancers and precancerous lesions, its role in the vulvar cancer is still unclear.

Methods: All publications in English language on the association between p16INK4a and clinicopathological features of vulvar cancer were searched from Pubmed, Embase, and Web of Science, and those in Chinese language were identified manually and online from the China National Knowledge Infrastructure. Strict inclusion and exclusion criteria were followed. Odds ratios (ORs) or risk ratios (RRs) with 95% confidence intervals (CIs) were pooled to assess the strength of association. Publication bias was estimated using funnel plots and the Egger's regression test.

Results: A total of 17 studies with 2309 patients were included. The p16INK4a overexpression was found to correlate significantly with the lower International Federation of Gynecology and Obstetrics stage (I+II vs III+IV; OR = 0.60, 95%CI: 0.41-0.86, P = 0.006), negative lymph node metastasis(negative vs positive; OR = 0.61, 95%CI: 0.39-0.95, P = 0.029), patient's age <55 (OR = 0.54, 95%CI: 0.31-0.96, P = 0.034), human papillomavirus-positive status (OR = 0.01, 95%CI: 0.00-0.11, P<0.001), and higher overall survival (RR = 0.53, 95%CI = 0.35-0.80, P = 0.003).

Conclusion: The p16INK4a might be associated with a higher survival and indicates better prognosis of vulvar cancer.

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Related in: MedlinePlus

Forest plot for the association between p16INK4a expression and clinicopathological markers(A) FIGO stage.(B) LN metastasis. (C) Patient's age. (D) HPV status. (E) Histological grade. FIGO, International Federation of Gynecology and Obstetrics; LN, lymph node; HPV, human papillomavirus.
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pone.0152459.g002: Forest plot for the association between p16INK4a expression and clinicopathological markers(A) FIGO stage.(B) LN metastasis. (C) Patient's age. (D) HPV status. (E) Histological grade. FIGO, International Federation of Gynecology and Obstetrics; LN, lymph node; HPV, human papillomavirus.

Mentions: As shown in Fig 2, the overexpression of p16INK4a was significantly associated with the lower FIGO stage of I–II(OR = 0.60,95%CI:0.41–0.86,P = 0.006,fixed effect; Fig 2A), no lymph node metastasis(OR = 0.61,95%CI:0.39–0.95,P = 0.029,fixed effect; Fig 2B), patient’s age<55(OR = 0.54,95%CI:0.31–0.96,P = 0.034,fixed effect; Fig 2C), and HPV-positive status(OR = 0.01,95%CI:0.00–0.11,P<0.001,random effect; Fig 2D).However, the overexpression of p16INK4a was not correlated with the histological grade(OR = 0.99,95%CI:0.71–1.39,P = 0.953,fixed effect; Fig 2E).


Prognostic Value of Overexpressed p16INK4a in Vulvar Cancer: A Meta-Analysis.

Cao H, Wang S, Zhang Z, Lou J - PLoS ONE (2016)

Forest plot for the association between p16INK4a expression and clinicopathological markers(A) FIGO stage.(B) LN metastasis. (C) Patient's age. (D) HPV status. (E) Histological grade. FIGO, International Federation of Gynecology and Obstetrics; LN, lymph node; HPV, human papillomavirus.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4816296&req=5

pone.0152459.g002: Forest plot for the association between p16INK4a expression and clinicopathological markers(A) FIGO stage.(B) LN metastasis. (C) Patient's age. (D) HPV status. (E) Histological grade. FIGO, International Federation of Gynecology and Obstetrics; LN, lymph node; HPV, human papillomavirus.
Mentions: As shown in Fig 2, the overexpression of p16INK4a was significantly associated with the lower FIGO stage of I–II(OR = 0.60,95%CI:0.41–0.86,P = 0.006,fixed effect; Fig 2A), no lymph node metastasis(OR = 0.61,95%CI:0.39–0.95,P = 0.029,fixed effect; Fig 2B), patient’s age<55(OR = 0.54,95%CI:0.31–0.96,P = 0.034,fixed effect; Fig 2C), and HPV-positive status(OR = 0.01,95%CI:0.00–0.11,P<0.001,random effect; Fig 2D).However, the overexpression of p16INK4a was not correlated with the histological grade(OR = 0.99,95%CI:0.71–1.39,P = 0.953,fixed effect; Fig 2E).

Bottom Line: Strict inclusion and exclusion criteria were followed.A total of 17 studies with 2309 patients were included.The p16INK4a overexpression was found to correlate significantly with the lower International Federation of Gynecology and Obstetrics stage (I+II vs III+IV; OR = 0.60, 95%CI: 0.41-0.86, P = 0.006), negative lymph node metastasis(negative vs positive; OR = 0.61, 95%CI: 0.39-0.95, P = 0.029), patient's age <55 (OR = 0.54, 95%CI: 0.31-0.96, P = 0.034), human papillomavirus-positive status (OR = 0.01, 95%CI: 0.00-0.11, P<0.001), and higher overall survival (RR = 0.53, 95%CI = 0.35-0.80, P = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu City, Sichuan Province, China.

ABSTRACT

Objective: This study aimed to examine the prognostic value of overexpressed p16INK4a in vulvar cancer. Although the tumor suppressor p16INK4a has been shown to be of prognostic value in a wide variety of cancers and precancerous lesions, its role in the vulvar cancer is still unclear.

Methods: All publications in English language on the association between p16INK4a and clinicopathological features of vulvar cancer were searched from Pubmed, Embase, and Web of Science, and those in Chinese language were identified manually and online from the China National Knowledge Infrastructure. Strict inclusion and exclusion criteria were followed. Odds ratios (ORs) or risk ratios (RRs) with 95% confidence intervals (CIs) were pooled to assess the strength of association. Publication bias was estimated using funnel plots and the Egger's regression test.

Results: A total of 17 studies with 2309 patients were included. The p16INK4a overexpression was found to correlate significantly with the lower International Federation of Gynecology and Obstetrics stage (I+II vs III+IV; OR = 0.60, 95%CI: 0.41-0.86, P = 0.006), negative lymph node metastasis(negative vs positive; OR = 0.61, 95%CI: 0.39-0.95, P = 0.029), patient's age <55 (OR = 0.54, 95%CI: 0.31-0.96, P = 0.034), human papillomavirus-positive status (OR = 0.01, 95%CI: 0.00-0.11, P<0.001), and higher overall survival (RR = 0.53, 95%CI = 0.35-0.80, P = 0.003).

Conclusion: The p16INK4a might be associated with a higher survival and indicates better prognosis of vulvar cancer.

Show MeSH
Related in: MedlinePlus