Can p63 serve as a biomarker for diagnosing giant cell tumor of bone? A systematic review and meta-analysis

Abstract

BACKGROUND: Tumor protein p63 (p63) has been reported to be highly expressed in giant cell tumor of bone (GCTB). Whether p63 can be treated as a diagnostic marker for GCTB remains unclear. OBJECTIVE: We conducted a meta-analysis to evaluate the applicability of p63 in diagnosing GCTB. DESIGN AND SETTING: Systematic review and meta-analysis carried out in a public hospital, Hong Kong, China. METHODS: We searched PubMed, EMBASE and the Cochrane Library from inception to April 30, 2019. Literature in English or Chinese about the differential diagnosis of GCTB using p63 were included. Animal experiments, reviews, correspondence, case reports, expert opinions and editorials were excluded. Studies were also excluded if they did not provide sufficient information to construct a 2 × 2 contingency table. We calculated individual and pooled sensitivities and specificities. We used I² as an indicator of heterogeneity. RESULTS: Out of 88 records identified, 8 articles on 788 GCTB patients fulfilled the inclusion criteria and were included in the present analysis. Bivariate analyses yielded a pooled mean sensitivity of 0.87 (95% confidence interval, CI, 0.72-0.95) and specificity of 0.71 (95% CI, 0.56-0.82) for using p63 as a biomarker in diagnosing GCTB. The area under the receiver operating characteristic curve was 0.86 (95% CI, 0.82-0.88). CONCLUSION: p63 is a helpful indicator in diagnosing GCTB due to its high sensitivity and specificity. Nonetheless, the results need to be carefully interpreted based on other diagnostic methods such as imaging. SYSTEMATIC REVIEW REGISTRATION: 164115 (PROSPERO registration number)

Updated concepts in treatment of giant cell tumor of bone

“…Both groups suggested using these biological markers for character assessment of bone neoplasms and to predict higher recurrence risks in PD-L1 expressing GCTB patients. Also, PD-L1 immune checkpoint inhibitors may be of clinical benefit for recurrent GCTB after denosumab [22 ▪▪ ].…”

Medical Therapy of Giant Cell Tumor of Bone

“…p63 has also been shown to be highly expressed in GCTB mononuclear neoplastic cells [65][66][67], but its usefulness is still to be determined. A meta-analysis of eight different studies including 335 GCTB patients showed that p63 is a helpful marker for GCTB diagnosis in critically ill patients, although it cannot be recommended as a single definitive diagnostic marker [68]. Finally, it has been suggested that high RANKL, IL-6, TNFα, SDF-1, and MCP-1 expression may help predict GCTB metastatic potential and prognosis, warranting further studies [69].…”