APC gene hypermethylation and prostate cancer: a systematic review and meta-analysis
APC gene hypermethylation and prostate cancer: a systematic review and meta-analysis
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DOI：
10.1038/ejhg.2012.281
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发表时间：
2013-09-01
影响因子：
5.2
通讯作者：
Hu, Yanling
中科院分区：
文献类型：
--
作者：
Chen, Yang;Li, Jie;Hu, Yanling
前列腺癌(PCa)是一种世界性疾病，影响大量男性。虽然使用了前列腺特异性抗原(PSA)筛查，但特异性有限。本研究分析了结肠腺瘤性息肉病(APC)甲基化检测体液和组织中PCA的敏感性和特异性。结合PubMed和Embase的搜索结果，纳入19项研究，其中5项涉及体液，14项涉及前列腺组织，涉及2344名受试者。在体液亚组中，合并的敏感度和特异度分别为0.53(95%可信区间：0.28-0.78)和0.92(95%可信区间：0.86-0.95)。组织学结果分别为0.84(95%CI：0.70~0.92)和0.91(95%CI：0.77~0.97)。为了证实结果，我们进行了进一步的分析，去掉了由于病例和对照的类型而引入高度异质性的研究。尿液敏感性0.46，95%CI：0.39~0.53；特异性0.87，95%CI：0.64~0.96；组织敏感性0.87，95%CI：0.72~0.94；特异性0.89，95%CI：0.68~0.97。此外，APC甲基化与PCa的交互作用分析显示，在整个数据集中有很强的相关性(优势比(OR)24.91，95%CI：12.86-48.24，I-2=72.5%)。合并相同的两个主要亚组(组织/液体)，合并OR分别为33.54(95%CI：14.88~75.59；I-2=70.7%)和8.20(95%CI：2.84~23.74，I-2=64.2%)。本研究结果提示，APC启动子甲基化可能成为PCa诊断的潜在检测手段，并为PCa的治疗提供了新的视角。
Prostate cancer (PCa) is a worldwide disease that affects a large number of males. Although prostate-specific antigen (PSA) screening is used, the specificity is limited. This study analyzes the sensitivity and specificity of adenomatous polyposis coli (APC) methylation for PCa detection in body fluids and tissues. Combining search results from PubMed and Embase, 19 studies were included, 5 involving body fluids and 14 involving prostate tissue, with 2344 subjects. In body fluid subgroups, the pooled sensitivity and specificity was 0.53 (95% confidence interval (CI): 0.28-0.78) and 0.92 (95% CI: 0.86-0.95), respectively. From tissue studies, the results presented as 0.84 (95% CI: 0.70-0.92) and 0.91 (95% CI: 0.77-0.97). To confirm the results, we conducted a further analysis by removing studies which introduced high heterogeneity due to the type of cases and controls. The same degree of sensitivity and specificity was presented in two subgroups (urine: sensitivity 0.46, 95% CI: 0.39-0.53; specificity 0.87, 95% CI: 0.64-0.96; tissue: sensitivity 0.87, 95% CI: 0.72-0.94; specificity 0.89, 95% CI: 0.68-0.97). In addition, analysis of the interaction between APC methylation and PCa showed strong association in the whole data set (odds ratio (OR) 24.91, 95% CI: 12.86-48.24, I-2 = 72.5%). Pooling the same two main subgroups (tissue/fluid) gave a pooled OR of 33.54 (95% CI: 14.88-75.59; I-2 = 70.7%) and 8.20 (95% CI: 2.84-23.74, I-2 = 64.2%), respectively. From this study, the results suggest that APC promoter methylation may be the potential testing for PCa diagnosis and provide a new viewpoint in the treatment of PCa.