Association between the epithelial cadherin-160C/A gene polymorphism and diffuse gastric cancer risk: a meta-analysis

Several previous studies have investigated whether the -160C/A epithelial cadherin promoter polymorphism confers an increased risk of diffuse gastric cancer (DGC), but conflicting results have been reported. To explore further the association of this polymorphism with DGC susceptibility, we performed an extensive search of relevant studies and conducted a meta-analysis to obtain a more precise estimate. We conducted a systematic literature search using the databases EMBASE, PubMed, and Web of Knowledge for reports published before August 2012 that met certain criteria. Information was carefully and independently extracted from all eligible publications by 2 of the authors. Twelve distinct data sets from 10 case-control studies were analyzed. They included 1115 cases of DGC and 2965 controls. Although none of the genotypes was associated with DGC risk, a slight trend of increased risk was found among A allele carriers [ odds ratio (OR) = 1.237, 95% confidence interval (95%CI), 0.940-1.627], CA heterozygotes (OR = 1.229, 95%CI = 0.938-1.610), and AA homozygotes (OR = 1.146, 95%CI = 0.684-1.918). However, when the cases were stratified by ethnicity, a diverging trend occurred in AA homozygotes between the Asian group ( OR = 0.710, 95%CI = 0.328-1.536) and its Caucasian counterpart ( OR = 1.434, 95%CI = 0.657-3.131). Taken together, the summarized analyses of these case-control studies demonstrated that the -160A of the epithelial cadherin gene exhibited no significant association with susceptibility for DGC; however, the results suggested that it is a potential genetic risk factor in both Asians and Caucasians. Additional large-scale, well-designed studies are necessary to confirm whether AA homozygosity is a protective factor in Asians.