Aberrant p53 Immunostaining in Barrett's Esophagus Predicts Neoplastic Progression: Systematic Review and Meta-Analyses.
Risk stratification of patients with Barrett's esophagus (BE) presently relies on the histopathologic grade of dysplasia found in esophageal biopsies, which is limited by sampling error and inter-pathologist variability. p53 immunostaining of BE biopsies has shown promise as an adjunct tool but is n...
| Publicado en: | Digestive Diseases & Sciences Vol. 64; no. 5; pp. 1089 - 1098 |
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| Autores principales: | , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
May2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136203053&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136203053 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01632116 1VP jtl: Digestive Diseases & Sciences issn: 01632116 maglogo: N pubinfo: dt: May2019 vid: 64 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 136203053 136203053 NLM30911864 136203053 10.1007/s10620-019-05586-7 NLM30911864 136203053 ppf: 1089 ppct: 9 formats: tig: atl: Aberrant p53 Immunostaining in Barrett's Esophagus Predicts Neoplastic Progression: Systematic Review and Meta-Analyses. aug: au: Snyder, Patrick Dunbar, Kerry Cipher, Daisha J. Souza, Rhonda F. Spechler, Stuart Jon Konda, Vani J. A. affil: Division of Gastroenterology, Department of Internal Medicine, Baylor University Medical Center, 3500 Gaston Avenue, 75246, Dallas, TX, USA sug: subj: Proteins Esophageal Neoplasms Metabolism Staining and Labeling Methods Barrett Esophagus Metabolism Adenocarcinoma Metabolism Barrett Esophagus Diagnosis Predictive Value of Tests Proteins Immunology Retrospective Design Esophageal Neoplasms Diagnosis Disease Progression Proteins Analysis Case Control Studies Human Prospective Studies Adenocarcinoma Diagnosis Meta Analysis Systematic Review ab: Risk stratification of patients with Barrett's esophagus (BE) presently relies on the histopathologic grade of dysplasia found in esophageal biopsies, which is limited by sampling error and inter-pathologist variability. p53 immunostaining of BE biopsies has shown promise as an adjunct tool but is not recommended by American gastroenterology societies, who cite insufficient evidence of its prognostic value. We have conducted a systematic review and meta-analyses to clarify this value. We searched for studies that: (1) used immunohistochemistry to assess p53 expression in esophageal biopsies of BE patients and (2) reported subsequent neoplastic progression. We performed separate meta-analyses of case-control studies and cohort studies. We identified 14 relevant reports describing 8 case-control studies comprising 1435 patients and 7 cohort studies comprising 582 patients. In the case-control study meta-analysis of the risk of neoplasia with aberrant p53 expression, the fixed- and random-effect estimates of average effect size with aberrant p53 expression were OR 3.84, p < .001 (95% CI 2.79-5.27) and OR 5.95, p < .001 (95% CI 2.68-13.22), respectively. In the cohort study meta-analysis, the fixed- and random-effect estimates of average effect size were RR = 17.31, p < .001 (95% CI 9.35-32.08) and RR = 14.25, p < .001 (95% CI 6.76-30.02), respectively. Separate meta-analyses of case-control and cohort studies of BE patients who had baseline biopsies with p53 immunostaining revealed consistent, strong, and significant associations between aberrant p53 immunostaining and progression to high-grade dysplasia or esophageal adenocarcinoma. These findings support the use of p53 immunostaining as an adjunct to routine clinical diagnosis for dysplasia in BE patients. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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