Abstract
BackgroundEpidermal growth factor (EGF) plays a pivotal role in cell proliferation, differentiation, and tumorigenesis of epithelial tissues. Variation of the EGF +61A/G (rs4444903) can lead to an alteration in EGF production and/or activity, which may result in individual susceptibility to gastric cancer. Studies investigating the association between EGF +61A/G polymorphism and gastric cancer risk produced inconsistent results. The aim of this study was to quantitatively summarize the evidence for such an association.MethodsEligible studies on the association between EGF +61A/G polymorphism and gastric cancer risk were identified by search of electronic databases including PubMed, EMBASE, Cochrane Library, and Chinese Biomedical Literature database (CBM). Data were extracted by two independent authors and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association. Metaregression and subgroup analyses were performed to identify the source of heterogeneity.ResultsFinally, six case–control studies with 1547 gastric cancer cases and 2762 controls were eventually identified. Overall, significant increased gastric cancer risk was found when all studies were pooled in the meta-analysis (GG vs. AA: OR = 1.438, 95% CI 1.021–2.025, P = 0.038; GG + AG vs. AA: OR = 1.256, 95% CI 1.025–1.539, P = 0.028; GG vs. AG + AA: OR = 1.265, 95% CI 1.002–1.596, P = 0.048). In subgroup analysis by ethnicity, source of control, study quality, and HWE in controls, significant increased gastric cancer risk was observed in Asians, population-based studies, high quality studies, and studies consistent with HWE. In subgroup analysis according to tumor location, and histological type, significant association was observed in all subgroups.ConclusionsThis meta-analysis suggested that the EGF +61A/G polymorphism contributes to increased gastric cancer risk, especially in Asian populations. Further well-designed studies based on large sample size in diverse populations are needed to confirm this association.
Highlights
Gastric cancer is one of the most common cancers and the second leading cause of cancer-related death in the world [1,2]
Most subjects with the above environmental risk factors never develop gastric cancer while many gastric cancer cases develop among individuals without the risk factors, suggesting that other factors such as genetic factors play an important role in gastric carcinogenesis
Characteristics of studies Based on the search strategy, seven studies evaluating the Epidermal growth factor (EGF) +61A/G polymorphism and gastric cancer susceptibility were identified
Summary
Gastric cancer is one of the most common cancers and the second leading cause of cancer-related death in the world [1,2]. Carcinogenesis of gastric cancer is a complex, multistep and multifactor process, in which many factors are involved. It has been well established that Helicobacter pylori (H. pylori) infection was the major risk factor for gastric cancer [3,4]. Most subjects with the above environmental risk factors never develop gastric cancer while many gastric cancer cases develop among individuals without the risk factors, suggesting that other factors such as genetic factors play an important role in gastric carcinogenesis. Variation of the EGF +61A/G (rs4444903) can lead to an alteration in EGF production and/or activity, which may result in individual susceptibility to gastric cancer. Studies investigating the association between EGF +61A/G polymorphism and gastric cancer risk produced inconsistent results. The aim of this study was to quantitatively summarize the evidence for such an association
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