Clinical ReportsClinicopathological significance and prognostic value of P27 expression in gastric cancer patients: a meta-analysisFeng, Huia; Zhang, Hongmeib; Yan, Zongtinga Author Information aDepartment of Laboratory Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine bPharmacy Department, People’s Hospital of Lixia District of Jinan, Jinan, Shandong, China Received 7 June 2021 Revised form accepted 29 June 2021 Correspondence to Zongting Yan, Department of Laboratory Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No.16369 Jingshi Road, Jinan 250011, Shandong, China, Tel: +86 13853108211; e-mail: [email protected] Anti-Cancer Drugs: January 2022 - Volume 33 - Issue 1 - p e692-e699 doi: 10.1097/CAD.0000000000001240 Buy Metrics Abstract Loss of P27 expression correlates with clinical progression in a variety of human cancers. However, the correlation between P27 expression and gastric cancer remains controversial. In this meta-analysis, we performed an electronic search based on six databases to select a sufficient number of studies. Pooled hazard ratio (HR) was used as estimates to investigate the association between P27 expression and prognosis of patients with gastric cancer. We identified 19 studies with 2387 gastric cancer patients, ranging between 50 and 316 samples per study. Q and I2 tests demonstrated that the homogeneity among 19 studies (I2 = 47%, P = 0.0004), thus we applied a fixed-effects model to calculate the pooled HR of P27expression and overall survival (OS) of gastric cancer patients was 0.68, and 95% confidence interval (CI) was 0.60–0.78. Next, we conducted a subgroup meta-analysis and found that patients with low P27 expression in Asians (HR = 0.69, 95% CI: 0.58–0.82) and non-Asians (HR = 0.57, 95% CI: 0.41–0.79) had poor prognosis. In addition, we found the publication bias results of OS in the final included 19 studies showed that this funnel plot presented incomplete symmetry, and then removed three literatures with larger HRs bias, and found that the remaining 16 literatures were homogeneity (I2 = 0%, P = 0.47), the pooled HR was 0.52 with 95% CI of 0.43-0.62, and the publication bias disappeared. These results suggested a strong association between P27 underexpression and poorer prognosis of gastric cancer in patients. P27 may be a tumor suppressor for predicting survival outcome of gastric cancer patients. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.