Expression of p63 in Squamous Cell Carcinoma of the Lung and its Diagnostic Significance: A Meta-Analysis

Abstract

 Introduction: The expression of p63 has been studied in various tumor types, including squamous cell carcinoma (SCC). Methods and Results: Twenty-five trials met the inclusion criteria with a total of 1,193 patients. The overall positive proportion of p63 was 91.5% (95% CI, 86.3-94.8). Both histological and cytological methods of obtaining specimens showed a high expression of p63 in SCC at 89.8% (95% CI, 81.9-94.5) and 88.7% (95% CI, 80.9-93.6). The p63 positive proportion of the well or moderately differentiated subgroups was 92.7% (95% CI, 77.9-97.9) compared to the poorly differentiated subgroup at 86.9% (95% CI, 61.6-96.5). When using >1% of p63 immunoreactive cells as the positive standard, both sensitivity and specificity at 0.91 (95% CI, 0.86-0.94) and 0.80 (95% CI, 0.75-0.85), respectively, were acceptable. When using >10% and >50% standards, sensitivities of 0.92 (95% CI, 0.90-0.94) and 0.82 (95% CI, 0.78-0.85) and specificities of 0.84 (95% CI, 0.82-0.86) and 0.92(95% CI, 0.90-0.94) were shown. Conclusions: In SCC, there is a high expression of p63, which has no association with the histological or cytological methods used to obtain specimens or the degree of differentiation of the specimens. Even when only a small amount of cells were stained (>1%) as the positive standard, the sensitivity and specificity of p63 were maintained at a high level. We suggest that >50% of immunoreactive cells be used as the positive standard to achieve proper sensitivity and specificity.