The discrepancy between genetic polymorphism of p53 codon 72 and the expression of p53 protein in Helicobacter pylori-associated gastric cancer in Korea

Perspectives on new biomarkers in gastric cancer: Diagnostic and prognostic applications

Gastric cancer is considered one of the most deadly tumors worldwide. Even with the decline in its incidence, the mortality rate of this disease has remained high, mainly due to its late diagnosis and to the lack of precise prognostic markers. The main purpose of this review is to present genetic, epigenetic and proteomic molecular markers that may be used in a diagnostic and prognostic manner and to discuss the pros and cons of each type of marker for improving clinical practice. In this sense, we observed that the use of genetic markers, especially mutations and polymorphisms, should be carefully considered, as they are strongly affected by ethnicity. Proteomic-based markers show promise, but the higher costs of the associated techniques continue to make this approach expensive for routine use. Alternatively, epigenetic markers appear to be very promising, as they can be detected in bodily fluids as well as tissues. However, such markers must be used carefully because epigenetic changes may occur due to environmental factors and aging. Despite the advances in technology and its access, to date, there are few defined biomarkers of prognostic and diagnostic use for gastric tumors. Therefore, the use of a panel of several approaches (genetic, epigenetic and proteomic) should be considered the best alternative for clinical practice.

Association between TLR2, MTR, MTRR, XPC, TP73, TP53 genetic polymorphisms and gastric cancer: a meta-analysis

OBJECTIVE

The aim of our meta-analyses is to test the association between six genetic polymorphisms and gastric cancer.

METHODS

A systematic search was performed for all the available candidate genes and gastric cancer among several online databases including PubMed, Embase, Web of Science, the Cochrane Library, CNKI and Wanfang online libraries. After a comprehensive screening, a total of six genes were harvested for the current meta-analyses. These genes include TLR2 (-196 to -174 ins>del), MTR (rs1805087), MTRR (rs1801394), XPC (rs2228001), TP73 (G4C14-A4T14), and TP53 (rs1042522).

RESULTS

Altogether 49 comparative studies among 11 776 cases and 18 633 controls were involved in our meta-analyses. TP53 rs1042522 polymorphism was shown to be associated with gastric cancer risk under the dominant model (P=0.02, OR=1.03, 95% CI=1.00-1.05). A subgroup meta-analysis indicated a significant association under dominant model between TP53 rs1042522 and gastric cancer in the Eastern Asians (P=0.03, OR=1.17, 95%=1.02-1.34).

CONCLUSIONS

These results suggest that TP53 rs1042522 polymorphism might contribute to the susceptibility of gastric cancer under the dominant model, especially in Eastern Asians.

Updated meta-analysis of the TP53 Arg72Pro polymorphism and gastric cancer risk

OBJECTIVE

The p53 tumor suppressor pathway plays an important role in gastric cancer (GC) development. Auto-regulatory feedback control of p53 expression is critical to maintaining proper tumor suppressor function. So far, several studies between p53 Arg72Pro polymorphism and GC have generated controversial and inconclusive results.

METHODS

To better assess the purported relationship, we performed a meta-analysis of 19 publications. Eligible studies were identified by searching the Pubmed database. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess any link.

RESULTS

Overall, a significant association was detected between the p53 Arg72Pro polymorphism and GC risk (Pro-allele vs. Arg-allele: OR=1.05, 95%CI=1.01-1.08; Pro/Pro vs. Arg/Arg: OR=1.13, 95%CI=1.04-1.22). Moreover, on stratified analysis by race, significantly increased risk was found for Asian populations (Pro-allele vs. Arg-allele: OR=1.06, 95%CI=1.02-1.10; Pro/Pro vs. Arg/Arg: OR=1.16, 95%CI=1.07-1.26; Pro/Pro+Pro/Arg vs. Arg/Arg: OR=1.58, 95%CI=1.09-2.27).

CONCLUSIONS

Our study provided evidence that the p53 72Pro allele may increase GC risk in Asians. Future studies with larger sample size are warranted to further confirm this association in more detail.

Pro variant of TP53 Arg72Pro contributes to gastric cancer risk in Asians: evidence from a meta-analysis

BACKGROUND

Previous studies investigating the association between TP53 Arg72Pro polymorphism and gastric cancer (GC) risk in Asian population have reported controversial results. Thus, a meta-analysis was performed.

METHODS

A comprehensive literature search was conducted and 17 case-control studies were finally included, involving a total of 5,990 GC cases and 6,812 controls. Subgroup analyses were performed by the sample size.

RESULTS

Meta-analysis of all 17 studies showed variant genotypes of TP53 Arg72Pro to be associated with an elevated GC risk in three genetic comparison models (OR(Pro vs. Arg)=1.13, 95%CI 1.03-1.25, P(OR)=0.01; OR(Homozygote comparison model)=1.33, 95%CI 1.07-1.64, P(OR)=0.009; OR(Dominant genetic model)=1.13, 95%CI 1.05-1.22, P(OR)=0.002). Besides, a more obvious association was observed after the heterogeneity was decreased (all P values less than 0.001). This association was further identified by both subgroup and sensitivity analyses.

CONCLUSIONS

This meta-analysis suggests the Pro variant of TP53 Arg72Pro contributes to gastric cancer risk in Asians.

Meta-analysis of the association between P53 codon 72 polymorphisms and gastric cancer

PURPOSE

This meta-analysis aims to examine whether the P53 codon 72 polymorphisms is associated with gastric cancer risk.

METHODS

Pooled odds ratios (ORs) were appropriately derived from random-effects models. Separate analyses were conducted on Asian and Caucasian populations. And a total of 21 studies were eligible (5,867 cases and 7,001 controls); 15 of them were conducted on Asians, others on Caucasians.

RESULTS

The combined results based on all studies showed that there was significant difference in genotype distribution between gastric cancer and non-cancer patients in the allele contrast (Pro vs. Arg); the codominant model (Pro/Pro vs. Arg/Arg) and the recessive model (Pro/Pro vs. Pro/Arg + Arg/Arg). When stratifying for race, patients with gastric cancer had a significantly higher frequency of Pro (OR = 1.136, 95% CI = 1.051-1.229), Pro/Pro (OR = 1.314, 95% CI = 1.110-1.555), Pro/Arg (OR = 1.099, 95% CI = 1.009-1.197), (Pro/Pro + Pro/Arg (OR = 1.153, 95% CI = 1.059-1.255) than non-cancer patients among Asians. There was statistically significant heterogeneity across all included studies with the Q statistic and study population may be the most important factor contributed to the heterogeneity.

CONCLUSIONS

In conclusion, the P53 codon 72 polymorphisms seems to be associated with gastric cancer risk and the analyses suggested that P53 codon 72 polymorphisms may be an important biomarker of gastric cancer susceptibility for Asians.

Association of p53 Arg72Pro polymorphism with gastric cancer: a meta-analysis

BACKGROUND

p53 tumor suppressor gene Arg72Pro polymorphism has been associated with gastric cancer. However, results were inconsistent. We performed this meta-analysis to estimate the association between p53 Arg72Pro polymorphism and gastric cancer.

METHODS

An electronic search of PubMed was conducted to select studies. Studies containing available genotype frequencies of Arg72Pro were chosen, and the association was assess by pooled odds ratio (ORs) with 95% confidence interval (CIs).

RESULTS

The meta-analysis suggested that the p53 Arg72Pro was associated with the gastric cancer risk (Additive model: OR = 1.149, 95% CI = 1.045-1.263, p = 0.004; Dominant model: OR = 1.18, 95% CI = 1.049-1.328, p = 0.006; Recessive model: OR = 1.202, 95% CI = 1.013-1.427, p = 0.035) in Asian subgroup.

CONCLUSION

This meta-analysis suggests that p53 Arg72Pro polymorphism is associated with increased risk of gastric cancer in Asians.

An updated meta-analysis of the p53 codon 72 polymorphism and gastric cancer risk

To investigate the association between p53 codon 72 polymorphisms and gastric cancer risk, a meta-analysis published in 2007 was updated with new data. Relevant literature was retrieved by searching PubMed and statistical analysis conducted using Review Manager software. Twenty-eight case-control studies were included in this meta-analysis, with 6,859 cases and 9,277 controls. The pooled results for all included studies showed that patients with gastric cancer had a borderline lower frequency of the Arg/Arg phenotype (odds ratio (OR) = 0.91, 95 % CI = 0.83-1.00, p = 0.04). When stratified for race, the difference in Arg/Arg frequency was significant among Asians (OR = 0.87, 95 % CI = 0.78-0.97, p = 0.01). On stratifying the various studies we found that, among Asians: (i) patients with cardial gastric cancer had a significantly higher frequency of the Pro/Pro genotype (OR = 1.35, 95 % CI = 1.03-1.77, p = 0.04) than those with non-cardial gastric cancer; (ii) patients with advanced (stage III/IV) gastric cancer had a significantly higher frequency of Arg/Arg (OR = 1.30, 95 % CI = 1.06-1.61, p = 0.01) than those with early (stage I/II) cancer; and (iii) patients with metastasis had a significantly higher frequency of Pro/Pro (OR = 3.31, 95 % CI = 1.31-8.41) than those without metastasis. Our study suggests that, among Asians, the p53 codon 72 Arg/Arg genotype is associated with a modestly decreased risk of gastric cancer, and that this difference in genotype distribution may be associated with cancer stage, location, differentiation and metastasis.

Associations between P53 Arg72Pro and development of digestive tract cancers: a meta-analysis

BACKGROUND AND AIMS

The relationships between P53 Arg72Pro and risks of digestive tract cancers have been extensively studied, and conclusive results were unavailable.

METHODS

Fifty three case-control studies were included through searching the databases of Medline, Embase and CNKI (up to August 2010). The odds ratio (OR) and 95% confidence interval (95% CI) were used to investigate the strength of the associations.

RESULTS

The results showed that there were no overall associations between P53 Arg72Pro and risks of digestive tract cancers. Subgroup analyses showed that P53 Arg72Pro was associated with risk of gallbladder and pancreatic cancer (OR [95% CI]: 1.44 [1.13-1.83] for Pro carriers vs. ArgArg). In addition, subgroup analyses also suggested that the Pro allele was associated with increased risks of digestive tract cancers among Asians (1.19 [1.01-1.42] for ProPro vs. ArgArg). Meanwhile, Pro allele was also suggested to be associated with increased risk of gastric cancer (1.33 [1.02-1.74] for ProPro vs. ArgPro for diffuse type of gastric cancer and 1.29 [1.05-1.57] for ProPro vs. Arg carriers for gastric cardia cancer) and colorectal cancer (1.26 [1.05-1.51] for ProPro vs. ArgPro for population-based case-control studies; 1.43 [1.09-1.87] for ProPro vs. ArgArg for colon cancer; 1.49 [1.09-2.06] for ProPro vs. ArgArg for rectal cancer and 2.22 [1.44-3.44] for ProPro vs. ArgArg for early stage of colorectal cancer).

CONCLUSIONS

This meta-analysis suggests that Pro allele in P53 Arg72Pro is significantly associated with the increased risks of digestive tract cancers, especially for Asians, and for gastric cancer, colorectal cancer and gallbladder and pancreatic cancer.