The association between p16INK4a and prognosis in endometrial carcinoma: a meta-analysis

Purpose of Investigation: P16(INK4a) has been suggested to be involved in the prognosis of various human malignancies. The purpose of this study was to analyze the prognostic impact of overexpressed p16(INK4a) in endometrial carcinoma. Materials and Methods: The PubMed, Embase, and Web of Science were searched for relevant publications in English language and the China National Knowledge Infrastructure was searched for studies in Chinese language. The pooled odds ratios (ORs) or risk ratios (RRs) with corresponding 95% confidence intervals (CIs) were used to assess the strength of association. Results: Overall, 26 studies with 1,628 patients were included. The p16(INK4a) overexpression was found to correlate significantly with the lower histological grade (OR = 0.44, 95% CI: 0.250.78, P = 0.005, random effect), negative lymph node metastasis (OR = 0.39, 95% CI: 0.20-0.76, P = 0.005, fixed effect) and <= 1/2 myometrial infiltration (OR = 0.63, 95% CI: 0.40-1.00, P = 0.05, fixed effect). However, no significant association was found between p16(INK4a) and FIGO (International Federation of Gynecology and Obstetrics) stage (OR= 0.80, 95% CI: 0.46-1.37, P = 0.409, random effect), histological type (OR= 1.21, 95% CI: 0.40-3.61, P = 0.735, random effect) or overall survival (RR = 0.74, 95% CI: 0.20-2.72, P = 0.653, random effect). Subgroup analysis indicated that the associations might differ based on geographical location, sample size, publication year, cut-off value, and study quality. Conclusion: The p16(INK4a) might be a potential biomarker for better prognosis of endometrial carcinoma.