TP53 Arg72Pro polymorphism is associated with esophageal cancer risk: a meta-analysis.

AIM: To investigate the association between TP53 Arg72Pro polymorphism and esophageal cancer (EC) risk using meta-analysis. METHODS: All eligible studies published before March 1, 2010 were selected by searching PubMed using keywords "p53" or "TP53", "polymorphism" or "variation", "esophageal" and "cancer" or "carcinoma". Crude odds ratios (ORs) with 95% confidence intervals (CIs) were assessed for EC risk associated with TP53 Arg72Pro polymorphism using fixed- and random-effects models. RESULTS: Nine case-control studies involving 5545 subjects were included in this meta-analysis. Significantly reduced risk of EC was associated with TP53 genotypes for Arg/Arg + Arg/Pro vs Pro/Pro (OR = 0.73, 95% CI: 0.57-0.94, P = 0.014). Subgroup analyses according to the source of controls and the specimens used for determining TP53 Arg72Pro genotypes or sample size showed that significantly reduced risk was observed only in studies which have population-based controls (Arg/Arg vs Pro/Pro: OR = 0.56, 95% CI: 0.47-0.66, P < 0.001), and use white blood cells or normal tissue to assess TP53 genotypes of cases (Arg/Arg vs Pro/Pro: OR = 0.56, 95% CI: 0.47-0.65, P < 0.001) or include at least 200 subjects (Arg/Arg vs Pro/Pro: OR = 0.56, 95% CI: 0.47-0.65, P < 0.001). Analysis restricted to well-designed studies also supported the significantly decreased risk of EC (Arg/Arg vs Pro/Pro: OR = 0.54, 95% CI: 0.46-0.64, P < 0.001). CONCLUSION: TP53 Arg72 carriers are significantly associated with decreased EC risk. Nevertheless, more well-designed studies are needed to confirm our findings.

TP53 Arg72Pro polymorphism and skin cancer risk: a meta-analysis.

The TP53 gene has an important role in the protection of cells from DNA damage due to UV exposure, and sequence variation in the gene may alter skin cancer susceptibility. To examine the association between the TP53 Arg72Pro polymorphism and skin cancer risk, we undertook a meta-analysis of 15 case-control studies involving 6,362 subjects. The quality of the studies was assessed according to a predefined scale. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were assessed for association using a random-effects model. Overall, no evidence of association was observed between TP53 genotypes and the risk of skin cancer in any genetic model (Arg/Arg vs. Pro/Pro: OR=1.05, 95% CI: 0.71-1.55; Arg/Pro vs. Pro/Pro: OR=0.92, 95% CI: 0.68-1.24; Arg/Arg+Arg/Pro vs. Pro/Pro: OR=0.97, 95% CI: 0.70-1.35; Arg/Arg vs. Arg/Pro+Pro/Pro: OR=1.15, 95% CI: 0.91-1.46). Stratified analyses according to ethnicity and quality score of the studies also detected no significant association in any subgroup. Furthermore, no effect of this polymorphism on subtype of skin cancer, such as melanoma, squamous cell carcinoma, and basal cell carcinoma, was observed. In conclusion, this meta-analysis suggests that the TP53 Arg72Pro polymorphism may have little involvement in skin cancer susceptibility.

TP53 Arg72Pro polymorphism and endometrial cancer risk: a meta-analysis.

Studies investigating the relationship between TP53 Arg72Pro polymorphism and endometrial cancer risk reported conflicting results. To explore a more precise estimate of the effect of this polymorphism on endometrial carcinogenesis, a meta-analysis was performed by searching eligible studies in PubMed. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association for codominant model (Arg/Arg vs. Pro/Pro, Arg/Pro vs. Pro/Pro), dominant model (Arg/Arg+Arg/Pro vs. Pro/Pro), and recessive model (Arg/Arg vs. Arg/Pro+Pro/Pro), respectively. Subgroup analyses were performed by Hardy-Weinberg equilibrium (HWE) in controls, the specimen of cases for determining TP53 genotypes, sample size, the source of control and case groups, and ethnicity. We identified 8 case-control studies involving 2,154 subjects for this meta-analysis. Overall, no evidence of association was observed between TP53 genotypes and endometrial cancer risk in all genetic models (Arg/Arg vs. Pro/Pro: OR=0.98, 95% CI: 0.69-1.39, P=0.90; Arg/Pro vs. Pro/Pro: OR=1.00, 95% CI: 0.71-1.42, P=0.98; dominant model: OR=0.99, 95% CI: 0.71-1.38, P=0.95; recessive model: OR=1.06, 95% CI: 0.80-1.41, P=0.95). Stratified analyses also detected no significant association in any subgroup, except among those studies with controls deviated from HWE in recessive model (OR=1.60, 95% CI: 1.07-2.39). In conclusion, we did not observe any evidence for a role of TP53 Arg72Pro polymorphism in endometrial cancer. The reported significant association between this polymorphism and endometrial cancer risk may be due to methodological errors such as selection bias, small sample size, Type I error, and population stratification.

Management of sternal osteomyelitis and mediastinal infection following median sternotomy.

BACKGROUND: Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy. METHODS: Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage. RESULTS: No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months. CONCLUSIONS: Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged sternal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

Meta-analysis of association between TP53 Arg72Pro polymorphism and bladder cancer risk.

OBJECTIVES: To perform a meta-analysis to explore a more robust estimate of the effect of the TP53 Arg72Pro polymorphism on bladder cancer risk. Studies investigating the association between TP53 Arg72Pro polymorphism and bladder cancer risk have reported conflicting results. METHODS: All eligible studies were searched in PubMed. The quality of the studies was evaluated according to a predefined scale. Crude odds ratios, with the 95% confidence intervals, were assessed for the association using fixed- and random-effects models. RESULTS: We identified 10 case-control studies involving 3549 subjects for the present meta-analysis. Overall, no evidence of an association was observed between the TP53 genotypes and bladder cancer susceptibility when all the studies were pooled into the meta-analysis. However, a significantly decreased risk of bladder cancer was associated with TP53 genotypes for Arg/Arg versus Pro/Pro (odds ratio 0.74, 95% confidence interval 0.55-0.99) and Arg/Arg plus Arg/Pro versus Pro/Pro (odds ratio 0.77, 95% confidence interval 0.59-1.00) in Asians. In contrast, no effect of this polymorphism on bladder cancer in whites, Africans, or other population was observed when only high-quality scored studies were considered. CONCLUSIONS: The results of the present meta-analysis suggest that the TP53 Arg72 allele is a protective factor and that the Pro/Pro genotype might increase the susceptibility to bladder cancer in Asians. The conflicting findings among studies might have resulted from variations in the allele frequencies among the different races, as well as the methodologic quality of the studies.