J Cancer 2017; 8(16):3296-3308. doi:10.7150/jca.19810 This issue Cite
Research Paper
1. State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, 510000, PR China;
2. Department of the VIP region, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China;
3. Department of Oncological Surgery, the Second People's Hospital of Lu-an City, Lu-an, 237000, PR China;
4. Department of Gynecology, Guangdong Women and Children Hospital, Guangzhou, 510010, PR China;
5. Department of the ICU, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China;
6. Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China.
* Equal contributors.
Microsatellites instability (MSI) is a risk factor for multiple primary cancers (MPCs). However, a variety of studies focused on the risk in the hereditary non-polyposis colorectal cancer (HNPCC) not the sporadic colorectal cancer (CRC) patients. The aim of this meta-analysis was to comprehensive overview and quantitative summary the association between MSI and risk of MPCs. A comprehensive literature search in MEDLINE, EMBASE, Web of science, ScienceDirect, Weily and OVID was conducted. Up to May 2016, we identified 22 observational studies. We calculated the summary relative risk (RR) for the risk of MPCs in MSI patients compared with microsatellites stability (MSS) patients using fixed- or random-effects models. The RR of the association between mismatch-repair gene (MMR) genotype and MPCs was 2.59 (95% confidence interval [CI], 2.06 to 3.27); the RR was 2.14 (95% CI, 1.78 to 2.57) for sporadic CRC and 5.59 (95% CI, 2.69 to 11.59) for HNPCC for the MSI versus MSS category. The subgroup analyses showed different mutant gene, mutant locus, and mutant level of MMR with different influence on the patients susceptible to MPCs. In addition, MSI genotype increase the risk of MPC was not associated with an apparently specific in regard to site, timing, age and detection method. In conclusion, this meta-analysis indicates that MSI is associated with an increased risk of MPCs both in the HNPCC and sporadic CRC patients. Our findings will form the backbone of the treatment for MSI genotype may be an important valuable strategy for MPCs prevention.
Keywords: microsatellites instability, multiple Primary Cancers, risk factor, meta-analysis.