The prognostic and clinical value of p53 upregulated modulator of apoptosis expression in solid tumors: a meta-analysis and TCGA data review

ABSTRACT

Background

Previous studies have reported the prognostic value of p53 upregulated modulator of apoptosis (PUMA) in numerous human tumors, but the conclusions have not been consistent. Therefore, this meta-analysis and the Cancer Genome Atlas (TCGA) data analysis were performed to estimate the prognostic significance of PUMA in solid tumors.

Research Design and Methods

A search was conducted in PubMed, Embase, Web of Science, Cochrane Library and CNKI up to 21 July 2022. In total, 10 studies with 2,207 patients were included. We extracted the overall survival (OS) and disease-free survival (DFS) data. The hazard ratios (HRs) and 95% confidence intervals (95% CI) were adopted for evaluating the association.

Results

Decreased PUMA expression was significantly associated with worse OS (HR = 0.54, 95% CI = 0.38–0.78) and worse DFS (HR = 0.54, 95% CI = 0.42–0.70). Subgroup analysis showed that the prognostic role of PUMA for OS was most significant in the digestive system (HR = 0.52, 95% CI = 0.38–0.69). Furthermore, the expression of PUMA was not affected by tumor differentiation or clinical stage, and TCGA dataset analysis confirmed these results.

Conclusions

We proved that expression of PUMA may serve as an independent prognostic factor for patients with solid tumors.

KEYWORDS:

• P53 upregulated modulator of apoptosis (PUMA)
• BCL2 binding component 3 (BBC3)
• tumor
• prognosis
• Meta-analysis
• TCGA dataset

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

Conceptualization, C.Z. and W.W.; methodology, Z.Y. and S.W.; software, X.Z. and S.L.; validation, K.N., G.L., Y.Z., Z.L. and L.L.; formal analysis, R.X., Q.Z. and Z.Y.; data curation, S.W., X.Z., X.L. and X.Z.; writing - original draft preparation, Z.Y. and S.W.; writing - review and editing, W.W. and C.Z.; supervision, C.Z.; project administration, C.Z. and W.W.; funding acquisition, C.Z. All authors have read and agreed to the published version of the manuscript.

Data Availability Statement

The data presented in this study are available upon request from the corresponding author.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737159.2022.2125802

Additional information

Funding

This study was funded by the Key R&D Projects in the Tianjin Science and Technology Pillar Program Grant (number 19YFZCSY00420), National Key R&D Program of China Grant (number 2017YFC1700604), National Key R&D Program of China Grant (number 2017YFC1700606) and Tianjin Key Medical Discipline (Specialty) Construction Project (number TJYXZDXK-044A).