Naing Cho, Aung Kyan, Lai Pei Kuan, Mak Joon Wah
School of Postgraduate Studies, International Medical University (IMU), Kuala Lumpur, 57000, Malaysia.
School of Medicine, International Medical University (IMU), Kuala Lumpur, Malaysia.
BMC Cancer. 2017 Jan 5;17(1):24. doi: 10.1186/s12885-016-2997-3.
Human chromosomes are capped and stabilized by telomeres. Telomere length regulates a 'cellular mitotic clock' that defines the number of cell divisions and hence, cellular life span. This study aimed to synthesize the evidence on the association between peripheral blood leucocytes (PBL) telomere length and the risk of colorectal cancer (CRC).
We searched relevant studies in electronic databases. When two or more observational studies reported the same outcome measures, we performed pooled analysis. All the analyses were performed on PBL using PCR. The odds ratio (OR) and its 95% confidence interval (CI) were used to assess the strength of association.
Seven studies (with 8 datasets) were included in this meta-analysis; 3 prospective studies, 3 retrospective studies and 1 study with a separate prospective and retrospective designs. The pooled analysis of 4 prospective studies (summary OR 1.01, 95% CI: 0.77-1.34, I :30%) and 4 retrospective studies (summary OR 1.65, 95% CI: 0.96-2.83, I :96%) showed no relationship between PBL telomere length and the CRC risk. A subgroup analysis of 2 prospective studies exclusively on females also showed no association between PBL telomere length and the CRC risk (summary OR, 1.17, 95% CI:0.72-1.91, I :57%).
The current analysis is insufficient to provide evidence on the relationship between PBL telomere length and the risk of CRC. Findings suggest that there may be a complex relationship between PBL telomere length and the CRC risk or discrepancy between genetics, age of patients and clinical studies. Future well powered, large prospective studies on the relationship between telomere length and the risk of CRC, and the investigations of the biologic mechanisms are recommended.
人类染色体由端粒加帽并稳定。端粒长度调节一个“细胞有丝分裂时钟”,该时钟定义了细胞分裂的次数,从而决定了细胞寿命。本研究旨在综合外周血白细胞(PBL)端粒长度与结直肠癌(CRC)风险之间关联的证据。
我们在电子数据库中检索相关研究。当两项或更多观察性研究报告相同的结局指标时,我们进行汇总分析。所有分析均使用PCR对PBL进行。优势比(OR)及其95%置信区间(CI)用于评估关联强度。
本荟萃分析纳入了7项研究(8个数据集);3项前瞻性研究、3项回顾性研究以及1项具有独立前瞻性和回顾性设计的研究。4项前瞻性研究的汇总分析(汇总OR 1.01,95% CI:0.77 - 1.34,I²:30%)和4项回顾性研究的汇总分析(汇总OR 1.65,95% CI:0.96 - 2.83,I²:96%)显示PBL端粒长度与CRC风险之间无关联。仅针对女性的2项前瞻性研究的亚组分析也显示PBL端粒长度与CRC风险之间无关联(汇总OR,1.17,95% CI:0.72 - 1.91,I²:57%)。
当前分析不足以提供PBL端粒长度与CRC风险之间关系的证据。研究结果表明PBL端粒长度与CRC风险之间可能存在复杂关系,或者在遗传学、患者年龄和临床研究之间存在差异。建议未来开展关于端粒长度与CRC风险关系的有充分效力的大型前瞻性研究,并对生物学机制进行研究。