Qin Zhiqiang, Li Xiao, Han Peng, Zheng Yuxiao, Liu Hanyu, Tang Jingyuan, Yang Chengdi, Zhang Jianzhong, Wang Kunpeng, Qi Xiaokang, Tang Min, Wang Wei, Zhang Wei
Department of Urology, The First Affiliated Hospital of Nanjing Medical University Department of Urologic Surgery, The affiliated Cancer Hospital of Jiangsu Province of Nanjing Medical University First Clinical Medical College of Nanjing Medical University, Nanjing Department of Urology, The First People's Hospital of Lianyungang City, Lianyungang Department of Urology, Subei People's Hospital, Yangzhou, China.
Medicine (Baltimore). 2017 Jun;96(25):e7258. doi: 10.1097/MD.0000000000007258.
Previous studies have been conducted to reveal the relationship between androgen receptor CAG polymorphism and risk of prostate cancer, yet the results were elusive and controversial. Thus, this meta-analysis was performed to clarify this association.
To obtain the relevant available studies, online databases PubMed, Embase, and Web of science were searched until September 1st, 2016. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of such association. Subgroup analyses were conducted based on ethnicity and source of controls. Moreover, Begg's funnel plots and Egger's linear regression test were conducted to test the publication bias.
Overall, our results enrolled 51 studies indicated that significant increased risk of prostate cancer was associated with androgen receptor CAG polymorphism (OR = 0.77, 95% CI: 0.67-0.89). In addition, compared with CAG repeat <20, 22, carriers of ≧20, 22 repeats had decreased risk of prostate cancer (cut-off point = 20: OR = 0.27, 95% CI: 0.13-0.52; cut-off point = 22: OR = 0.82, 95% CI: 0.70-0.97). However, when cut-off point = 23, no significant result was detected in such association (pooled OR = 0.88, 95% CI: 0.63-1.24). When cut-off point is 22, the results were positive only in Asian population (OR = 0.53, 95% CI: 0.32-0.89) in the subgroup analysis by ethnicity. Besides, when the studies were stratified by source of controls, the results were not significant in both the subgroup of population-based controls and hospital-based controls.
This meta-analysis suggested the carriers of short polymorphic CAG repeats might increase susceptibility to prostate cancer, which held potential as a detecting marker of the risk of prostate cancer.
此前已有研究试图揭示雄激素受体CAG多态性与前列腺癌风险之间的关系，但结果并不明确且存在争议。因此，进行了这项荟萃分析以阐明这种关联。
为获取相关的可用研究，检索了在线数据库PubMed、Embase和Web of science，检索截至2016年9月1日。采用合并比值比（OR）及95%置信区间（CI）来评估这种关联的强度。基于种族和对照来源进行亚组分析。此外，采用Begg漏斗图和Egger线性回归检验来检测发表偏倚。
总体而言，纳入51项研究的结果表明，雄激素受体CAG多态性与前列腺癌风险显著增加相关（OR = 0.77，95% CI：0.67 - 0.89）。此外，与CAG重复次数<20、22相比，CAG重复次数≧20、22的携带者患前列腺癌的风险降低（截断点 = 20：OR = 0.27，95% CI：0.13 - 0.52；截断点 = 22：OR = 0.82，95% CI：0.70 - 0.97）。然而，当截断点 = 23时，未检测到这种关联有显著结果（合并OR = 0.88，95% CI：0.63 - 1.24）。当截断点为22时，在按种族进行的亚组分析中，仅在亚洲人群中结果呈阳性（OR = 0.53，95% CI：0.32 - 0.89）。此外，当按对照来源对研究进行分层时，在基于人群的对照亚组和基于医院的对照亚组中结果均不显著。
这项荟萃分析表明，CAG短多态性重复序列的携带者可能增加患前列腺癌的易感性，这有望作为前列腺癌风险的检测标志物。
