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Luan X, Niu P, Wang W, Zhao L, Zhang X, Zhao D, Chen Y. Sex Disparity in Patients with Gastric Cancer: A Systematic Review and Meta-Analysis. JOURNAL OF ONCOLOGY 2022; 2022:1269435. [PMID: 36385957 PMCID: PMC9646304 DOI: 10.1155/2022/1269435] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 07/25/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to ascertain whether sex-based differences influence clinicopathological characteristics and survival outcomes of gastric cancer patients. BACKGROUND Gastric cancer in females has received less attention than in males. Clinicopathological features and survival outcomes of females with gastric cancer have been reported in several studies with controversial results. METHODS We systematically reviewed clinical studies from PubMed, Cochrane Library, Embase, and Web of Science published up to June 2022. The effect sizes of the included studies were estimated using odds ratios (ORs). Heterogeneity was investigated using the χ2 and I 2 tests, while sensitivity analyses were performed to identify the source of substantial heterogeneity. All data used in this study were obtained from previously published studies obviating the need for ethical approval and patient consent. RESULTS Seventy-six studies with 775,003 gastric cancer patients were included in the meta-analysis. Gastric cancer patients were less likely to be females (P < 0.00001). Female patients were younger in age (P < 0.00001) and showed a higher percentage of distal (P < 0.00001), non-cardia (P < 0.00001), undifferentiated (P < 0.00001), diffuse (P < 0.00001), and signet-ring cell carcinoma (P < 0.00001). Female patients showed better prognosis in both 3-year (P = 0.0003) and 5-year overall survival (OS) (P < 0.00001), especially White patients. However, females were associated with lower 5-year OS relative to males in the younger patients (P = 0.0001). CONCLUSIONS In conclusion, gender differences were observed in clinicopathological characteristics and survival outcomes of gastric cancer. Different management of therapy will become necessary for different genders.
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Affiliation(s)
- Xiaoyi Luan
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Penghui Niu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Wanqing Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Lulu Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Xiaojie Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Dongbing Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Yingtai Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
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Zheng D, Williams C, Vold JA, Nguyen JH, Harnois DM, Bagaria SP, McLaughlin SA, Li Z. Regulation of sex hormone receptors in sexual dimorphism of human cancers. Cancer Lett 2018; 438:24-31. [PMID: 30223066 PMCID: PMC6287770 DOI: 10.1016/j.canlet.2018.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/24/2018] [Accepted: 09/03/2018] [Indexed: 02/07/2023]
Abstract
Gender differences in the incidences of cancers have been found in almost all human cancers. However, the mechanisms that underlie gender disparities in most human cancer types have been under-investigated. Here, we provide a comprehensive overview of potential mechanisms underlying sexual dimorphism of each cancer regarding sex hormone signaling. Fully addressing the mechanisms of sexual dimorphism in human cancers will greatly benefit current development of precision medicine. Our discussions of potential mechanisms underlying sexual dimorphism in each cancer will be instructive for future cancer research on gender disparities.
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Affiliation(s)
- Daoshan Zheng
- Department of Cancer Biology, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Cecilia Williams
- Department of Biosciences and Nutrition, KTH Royal Institute of Technology, Karolinska Institutet, Science for Life Laboratory, Stockholm, Sweden
| | - Jeremy A Vold
- Mayo Cancer Registry, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Justin H Nguyen
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Denise M Harnois
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sanjay P Bagaria
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sarah A McLaughlin
- Department of Surgery, and Mayo Clinic Cancer Center, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Zhaoyu Li
- Department of Cancer Biology, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Karim S, Ali A. Correlation of p53 over-expression and alteration in p53 gene detected by polymerase chain reaction-single strand conformation polymorphism in adenocarcinoma of gastric cancer patients from India. World J Gastroenterol 2009; 15:1381-7. [PMID: 19294769 PMCID: PMC2658834 DOI: 10.3748/wjg.15.1381] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the alterations in p53 gene among Indian gastric cancer patients and to correlate them with the various clinicopathological parameters.
METHODS: A total of 103 gastric cancer patients were included in this study. The p53 alterations were studied by both immunohistochemical method as well as polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) analysis. We only studied four (exon 5, 6, 7, and 8) of the 11 p53 exons. The alterations in p53 were also correlated with respect to various clinicopathological parameters.
RESULTS: Among 103 cases, p53 over-expression and alteration were detected in 37 (35.92%) and 19 (18.44%) cases, respectively. Most of the p53 alterations were found at exon 5 (31.54%), followed by exon 6 (26.31%), exon 7 (21.04%) and exon 8 (21.04%). A significant correlation of p53 over-expression was found with p53 alteration (P = 0.000). Concordance between p53 alteration (as detected by SSCP) and over-expression [as detected by immunohistochemistry (IHC)] was found in 75% cases. We found that IHC-positive/SSCP-negative cases accounted for 21% of cases and IHC-negative/SSCP-positive cases accounted for remaining 4% cases.
CONCLUSION: Our results show that p53 gene mutations are significantly correlated with p53 protein over-expression, with 75% concordance in over-expression and alteration in the p53 gene, but 25% disconcordance also cautions against the assumption that p53 over-expression is always associated with a gene mutation. There may be other mechanisms responsible for stabilization and accumulation of p53 protein with no evidence of gene mutation that reflect an accumulation of a non-mutated protein, or a false negative SSCP result.
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Chandanos E, Lagergren J. Oestrogen and the enigmatic male predominance of gastric cancer. Eur J Cancer 2008; 44:2397-403. [PMID: 18755583 DOI: 10.1016/j.ejca.2008.07.031] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 07/14/2008] [Accepted: 07/17/2008] [Indexed: 12/18/2022]
Abstract
Gastric cancer is the second most common cause of cancer death worldwide, and annually it causes over 150,000 deaths in Europe and 700,000 deaths globally. The incidence of gastric cancer shows an enigmatic male dominance with a male-to-female ratio of about 2:1. This sex ratio cannot be entirely attributed to the differences in the prevalence of known risk factors between the sexes. This review focuses on the potential role of oestrogen in explaining the male predominance in gastric cancer. Some data argue in favour of sex hormonal influence. Women with a longer fertility life and those on hormone replacement therapy seem to have a decreased risk of gastric cancer, and men who have been treated with oestrogen for prostate cancer have a decreased risk. Use of tamoxifen in women seems to increase their risk of gastric cancer. Animal studies indicate that oestrogen may offer protection against the development of this cancer as for example ovariectomised mice are at an increased risk, whilst administration of female sex hormones decreases the incidence of gastric cancer. Oestrogen may exert its effect by acting on oestrogen receptors (ERs). Both ERalpha, ERbeta and the latest discovered ERbetacx have been identified in gastric tissue. The biological means behind this is not yet clear but various mechanisms have been suggested. There are indications that oestrogen may lead to an increased expression of trefoil factor proteins, which protect mucous epithelia or inhibit the expression of c-erb-2 oncogene.
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Affiliation(s)
- Evangelos Chandanos
- Unit of Esophageal and Gastric Research (ESOGAR), Section of Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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Bani-Hani KE, Yaghan RJ, Heis HA, Shatnawi NJ, Matalka II, Bani-Hani AM, Gharaibeh KA. Gastric malignancies in Northern Jordan with special emphasis on descriptive epidemiology. World J Gastroenterol 2004; 10:2174-8. [PMID: 15259060 PMCID: PMC4724987 DOI: 10.3748/wjg.v10.i15.2174] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: To study the epidemiology of gastric malignancies in Jordan as a model for Middle East countries where such data is scarce.
METHODS: Pertinent epidemiological and clinicopathological data for 201 patients with gastric malignancy in north of Jordan between 1991 and 2001 were analyzed.
RESULTS: Male: female ratio was 1.8:1. The mean age was 61.2 years, and 8.5% of the patients were younger than 40 years of age. The overall age- adjusted incidence was 5.82/100 000 population/year. The age specific incidence for males raised from 1.48 in those aged 30-39 years to 72.4 in those aged 70-79 years. Adenocarcinomas, gastric lymphomas, malignant stromal tumors, and carcinoids were found in 87.5%, 8%, 2.5%, and 2% respectively. There was an average of 10.1-month delay between the initial symptoms and the diagnosis. Only 82 patients underwent “curative” gastrectomy. Among adenocarcinoma groups, Lauren intestinal type was the commonest (72.2%) and the distal third was the most common localization (48.9%). The mean follow up for patients with gastric adenocarcinoma was 25.1 mo (range 1 mo -132 mo) . The 5-year survival rates for stages I (n = 15), II (n = 41), III (n = 59), and IV (n = 53) were 67.3%, 41.3%, 5.7%, and 0% respectively (P = 0.0001). The overall 5 year survival was 21.1%.
CONCLUSION: Despite low incidence, some epidemiological features of gastric cancer in Jordan mimic those of high-risk areas. Patients are detected and treated after a relatively long delay. No justification in favor of a possible gastric cancer screening effort in Jordan is supported by our study; rather, the need of an earlier diagnosis and subsequent better care.
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Affiliation(s)
- Kamal-E Bani-Hani
- Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan.
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Han JY, Son H, Lee WC, Choi BG. The correlation between gastric cancer screening method and the clinicopathologic features of gastric cancer. Med Oncol 2004; 20:265-69. [PMID: 14514976 DOI: 10.1385/mo:20:3:265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2003] [Accepted: 03/22/2003] [Indexed: 02/04/2023]
Abstract
BACKGROUND A gastric cancer (GC) screening program using gastrofiberscopy (GFS) or double contrast upper gastrointestinal series (UGIS), as a public policy, has been used in Korea since 1996. The aim of this study was to assess whether there have been major changes in clinicopathologic features of GC by introducing GC screening. METHOD We reviewed the medical records of 1478 consecutive patients with GC who underwent gastrectomy between 1989 and 1999. Patients were divided into two groups: group I (before GC screening), 1989-1995 (n = 840), and group II (after GC screening), 1996-1999 (n = 638). RESULTS After employment of GC screening, the incidence of early cancer was significantly increased (21% vs 13%, p < 0.0001). During these years, the proportion of patients using GFS as the first diagnostic procedure and the relative frequency of intestinal-type GC increased significantly (63% vs 84%, 0.6 vs 1.2, respectively, p < 0.0001). CONCLUSIONS These results suggest that GC screening is effective for early detection of GC. Furthermore, the preferred screening method of GC can attribute the clinicopathologic features of GC.</p>
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Affiliation(s)
- Ji-Youn Han
- Research Institute & Hospital, National Cancer Center, Goyang, Korea.
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Wu CW, Li AF, Chi CW, Huang CL, Shen KH, Liu WY, Lin W. Human gastric cancer kinase profile and prognostic significance of MKK4 kinase. THE AMERICAN JOURNAL OF PATHOLOGY 2000; 156:2007-15. [PMID: 10854223 PMCID: PMC1850082 DOI: 10.1016/s0002-9440(10)65073-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Alterations of protein tyrosine kinase are often associated with uncontrolled cell growth and tumor progression. Knowledge of the overall expression pattern of tyrosine kinases should prove beneficial in understanding the signaling pathways involved in gastric cancer oncogenesis and in providing possible biomarkers for gastric cancer progression. To establish a general tyrosine-kinase expression profile, degenerated polymerase chain reaction primers designed from the consensus catalytic kinase motifs were used to amplify protein tyrosine kinase molecules from gastric cancer tissues. We observed more than 50 tyrosine and serine/threonine kinases from matching pairs of gastric cancer tissue and normal mucosa. Based on this new kinase profile information, we selected the MKK4 gene for further immunohistochemical studies. Statistical analysis of MKK4 protein expression and clinicopathological features indicated that MKK4 kinase expression could serve as a significant prognostic factor for relapse-free survival and for overall survival. We demonstrated a simple and sensitive method for establishing protein tyrosine-kinase expression profiles of human gastric cancer tissues as well as for discovering novel and useful clinical biomarkers from such kinase expression profiles.
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Affiliation(s)
- C W Wu
- Department of Surgery, Veterans General Hospital-Taipei and School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
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Shen KH, Wu CW, Lo SS, Hsieh MC, Hsia CY, Chiang SC, Lui WY. Factors correlated with number of metastatic lymph nodes in gastric cancer. Am J Gastroenterol 1999; 94:104-8. [PMID: 9934739 DOI: 10.1111/j.1572-0241.1999.00779.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We had previously reported a reasonable categorization of the number of positive lymph nodes (LN: 0, 1-4, 5-8, and > 8) as a prognostic indicator. This study was an extension, to see which factors correlated with number of positive lymph nodes. METHODS A total of 533 patients with gastric adenocarcinoma, who underwent curative surgery between January 1988 and December 1995, were entered into this study. Patients were divided into four groups according to metastatic LN number (0, 1-4, 5-8, and > 8). Their survival and clinicopathological factors were analyzed. RESULTS A total of 16,457 LNs, with an average of 30.9 per specimen, were removed, of which 1686 (10.2%) showed metastases. The 5-yr cumulative survival rate decreased as the number of metastatic LNs increased, ie., 91.3% for LN 0; 67.4% for LN 1-4; 37.2 for LN 5-8, and 14.1% for LN > 8. Multivariate analyses showed that depth of cancer invasion (odds ratio: 2.4), gross appearance (odds ratio: 1.9), size (odds ratio: 1.9), and location (odds ratio: 1.4) of tumor were four independent factors correlated with the number of metastatic LNs. Number of metastatic LNs increased with advanced Japanese nodal stage and UICC-TNM stage. CONCLUSIONS Depth of tumor invasion, and gross appearance, size, and location of tumor were four pathological factors independently correlated with number of metastatic LNs in gastric cancer.
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Affiliation(s)
- K H Shen
- Department of Surgery and Biostatistic Information Service Center, Veterans General Hospital-Taipei and National Yang Ming University, Taiwan, R.O.C
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