APC基因甲基化与上消化道肿瘤发病风险关联的Meta分析

Meta-analysis of the association between APC gene methylation and the risk of upper digestive tract tumor

目的:探讨腺瘤性结肠息肉病(adenomatous polyposis coli,APC)基因甲基化与上消化道肿瘤发病风险的关联。方法:系统检索PubMed、Web of Science、Embase、CNKI等数据库,英文检索词为"APC""methylation""esophageal cancer/esophagus cancer""gastric cancer/stomach cancer",中文检索词为APC、甲基化、食管癌、胃癌,同时辅以人工检索参考文献。检索范围为2000年1月—2018年2月。应用固定效应模型或随机效应模型计算合并OR值及其95%CI。结果:入选研究共17项,病例组共1201例,对照组共959例,数据表现为异质性。APC甲基化与上消化道肿瘤发病关联强度较高(OR=13.24,95%CI:6.42~27.33,P<0.001)。同时APC甲基化与TNM分期也存在关联(OR=3.95,95%CI:1.46~10.66,P=0.007)。结论:APC基因甲基化与上消化道肿瘤发病关联程度明显,应用于上消化道肿瘤早期诊断价值较大。

Objective:To investigate the association between methylation of adenomatous polyposis coli(APC)gene and the risk of upper digestive tract tumor.Methods:Relevant articles were identified using PubMed,Web of Science,Embase and China National Knowledge Infrastructure(CNKI)database.We used the keywords"APC"and"methylation",in conjunction with any of the following terms:"esophageal cancer","esophagus cancer","gastric cancer"or"stomach cancer".References listed in the identified articles were further manually searched for additional studies.The search range was from January 2000 to February 2018.A random or fixed effect model was adopted to calculate pooled odd ratio with 95%confidence interval.Results:The current Meta-analysis included 17 studies with 1201 cases and 959 controls.The significant heterogeneity was across studies.The pooled OR of APC methylation was13.24(95%CI:6.42-27.33,P<0.001)for upper digestive tract tumor.A significant association was found between the hypermethylation frequency and the increased TNM stages(pooled OR:3.95,95%CI:1.46-10.66,P=0.007).Conclusion:The present Meta-analysis provides evidence that APC promoter methylation is associated with an increased risk in upper digestive tract tumor.Our findings underscore the clinical relevance of aberrant methylation as a promising biomarker for upper digestive tract tumor.