Yang Wen-Jun, Wang Ming-Yue, Pan Fu-Ze, Shi Chen, Cen Hong
Department of Gastroenterology, The Second Affiliated Hospital of Guilin Medical University, Gui Lin, 541100, China.
Department of Chemotherapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
World J Surg Oncol. 2017 Aug 2;15(1):144. doi: 10.1186/s12957-017-1183-7.
Though a number of studies have been conducted to explore the association between myeloperoxidase (MPO)-463G > A polymorphism and cancer risk, the results remain inconsistent. Therefore, we performed a meta-analysis to derive a more systematic estimation of this relationship.
Relevant studies were searched by PubMed, EMBASE, CNKI, Google Scholar, Ovid, and Cochrane library prior to December 2015. The strength of the association between MPO-463G > A polymorphism and cancer risk was estimated by odds ratios (OR) with 95% confidence interval (95%CI). Cumulative analysis was used to evaluate the stability of results through time.
The current analysis consisted of 16,858 cases and 21,756 controls from 60 studies. Pooled results showed that MPO-463G > A polymorphism were associated with the overall decreased cancer susceptibility in all the genetic models included in this study (additive model: OR = 0.84, 95%CI = 0.76-0.94; allele genetic model: OR = 0.90, 95%CI = 0.840-0.954; recessive genetic model: OR = 0.89, 95%CI = 0.83-0.95). However, in the stratified analysis of cancer type, the significant results were only found in lung cancer (dominant model: OR = 0.93, 95%CI = 0.87-0.99) and digestive system cancer groups (dominant model: OR = 0.67 0.53-0.84; allele frequency model = 0.71, 95%CI = 0.57-0.87), but not in the blood system cancer or breast cancer group. When we further stratified the digestive system cancer group into digestive tract and digestive gland cancer groups, results showed a significant association between allele A of MPO-463G > A and digestive gland cancer in all the genetic models (allele frequency model: OR = 0.63, 95%CI = 0.40-0.99; additive model: OR = 0.41, 95%CI = 0.23-0.73; recessive model: OR = 0.51, 95%CI = 0.29-0.89; dominant model: OR = 0.58, 95%CI = 0.35-0.96), digestive tract cancers in allele frequency model (OR = 0.75, 95%CI = 0.59-0.95), and dominant model (OR = 0.72, 95%CI = 0.56-0.92). When stratified by ethnicity, results demonstrated that the genotype A might be a protect factor for both Caucasians and Asians. In group analysis according to source of controls, significant results were found in population from hospital in all the genetic models. In cumulative analysis, result of allele contrast showed a declining trend and increasingly narrower 95% overall, while the inclination toward non-significant association with lung cancer risk.
This meta-analysis suggested that MPO-463G > A polymorphism was associated with the overall reduced cancer susceptibility significantly. It might be a more reliable predictor of digestive system cancer instead of lung cancer, blood system cancer, and breast cancer. In cumulative analysis, the stable trend indicated that evidence was sufficient to show the association between MPO-463G > A polymorphism and cancer risk.
尽管已经进行了多项研究来探讨髓过氧化物酶(MPO)-463G>A多态性与癌症风险之间的关联,但其结果仍不一致。因此,我们进行了一项荟萃分析,以更系统地评估这种关系。
在2015年12月之前,通过PubMed、EMBASE、中国知网、谷歌学术、Ovid和Cochrane图书馆检索相关研究。通过比值比(OR)及95%置信区间(95%CI)来估计MPO-463G>A多态性与癌症风险之间关联的强度。采用累积分析来评估结果随时间的稳定性。
当前分析纳入了来自60项研究的16858例病例和21756例对照。汇总结果显示,在本研究纳入的所有遗传模型中,MPO-463G>A多态性与总体癌症易感性降低相关(相加模型:OR = 0.84,95%CI = 0.76 - 0.94;等位基因遗传模型:OR = 0.90,95%CI = 0.840 - 0.954;隐性遗传模型:OR = 0.89,95%CI = 0.83 - 0.95)。然而,在癌症类型的分层分析中,仅在肺癌(显性模型:OR = 0.93,95%CI = 0.87 - 0.99)和消化系统癌症组(显性模型:OR = 0.67,95%CI = 0.53 - 0.84;等位基因频率模型:OR = 0.71,95%CI = 0.57 - 0.87)中发现显著结果,而在血液系统癌症或乳腺癌组中未发现。当我们将消化系统癌症组进一步细分为消化道和消化腺癌症组时,结果显示在所有遗传模型中,MPO-463G>A的A等位基因与消化腺癌症之间存在显著关联(等位基因频率模型:OR = 0.63,95%CI = 0.40 - 0.99;相加模型:OR = 0.41,95%CI = 0.23 - 0.73;隐性模型:OR = 0.51,95%CI = 0.29 - 0.89;显性模型:OR = 0.58,95%CI = 0.35 - 0.96),在等位基因频率模型(OR = 0.75,95%CI = 0.59 - 0.95)和显性模型(OR = 0.72,95%CI = 0.56 - 0.92)中与消化道癌症存在显著关联。按种族分层时,结果表明基因型A可能对高加索人和亚洲人都是一个保护因素。在根据对照来源进行的分组分析中,在所有遗传模型中均在医院人群中发现了显著结果。在累积分析中,等位基因对比结果显示总体呈下降趋势且95%CI越来越窄,同时与肺癌风险的关联倾向于无显著性。
这项荟萃分析表明,MPO-463G>A多态性与总体癌症易感性显著降低相关。它可能是消化系统癌症而非肺癌、血液系统癌症和乳腺癌的更可靠预测指标。在累积分析中,稳定的趋势表明有足够的证据显示MPO-463G>A多态性与癌症风险之间的关联。