Background: The role of the anti-apoptotic protein p27 in non-small cell lung cancer (NSCLC) remains controversial. To clarify its association with survival in NSCLC, we performed a systematic review of the literature with meta-analysis.
Methods: Trials were selected for further analysis if they provided an independent assessment of p27 in NSCLC and reported the analysis of survival data based on p27 status. A total of 11 trials, which comprised 1646 patients, provided sufficient information for the meta-analysis. Sensitivity analyses were conducted using histology, disease stage and ethnicity.
Results: The combined hazard ratio (HR) of 1.50 (95% CI=1.15-1.97; P<0.001 for heterogeneity) suggested that high p27 expression has a favorable impact on survival. When the studies were restricted to those of East Asian populations, patients that expressed high levels of p27 showed a better survival rate (HR 1.73, 95% CI=1.36-2.21; P=0.169 for heterogeneity) than those that did not express high levels of p27. In addition, the heterogeneity and publication bias disappeared.
Conclusion: In NSCLC, high p27 expression is associated with a better prognosis among East Asians.
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