Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 7, 2011; 17(25): 3043-3048
Published online Jul 7, 2011. doi: 10.3748/wjg.v17.i25.3043
P16 gene hypermethylation and hepatocellular carcinoma: A systematic review and meta-analysis
Jia-Jie Zang, Feng Xie, Jin-Fang Xu, Ying-Yi Qin, Rong-Xi Shen, Jia-Mei Yang, Jia He
Jia-Jie Zang, Feng Xie, Jin-Fang Xu, Ying-Yi Qin, Jia He, Department of Health Statistics, Second Military Medical University, Shanghai 200433, China
Feng Xie, Rong-Xi Shen, Jia-Mei Yang, Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Zang JJ and Xie F contributed equally to this work; Zang JJ and Xie F designed the research; Zang JJ, Xie F, Xu JF, Qin YY and Shen RX performed the research and analyzed the data; Zang JJ and Xie F wrote the paper; Yang JM and He J supervised the whole study.
Supported by The Ministry of Science and Technology of China, No. 2009ZX09312-025 and No. 2008ZX10002-018
Correspondence to: Jia He, MD, PhD, Department of Health Statistics, Second Military Medical University, Shanghai 200433, China. hejia63@yahoo.com
Telephone: +86-21-81871441 Fax: +86-21-81871441
Received: December 23, 2010
Revised: March 17, 2011
Accepted: March 24, 2011
Published online: July 7, 2011
Abstract

AIM: To quantitatively investigate the effect of p16 hypermethylation on hepatocellular carcinoma (HCC) and hepatocirrhosis using a meta-analysis of available case-control studies.

METHODS: Previous studies have primarily evaluated the incidence of p16 hypermethylation in HCC and corresponding control groups, and compared the incidence of p16 hypermethylation in tumor tissues, pericancer liver tissues, normal liver tissues and non-tumor liver tissues with that in other diseases. Data regarding publication information, study characteristics, and incidence of p16 hypermethylation in both groups were collected from these studies and summarized.

RESULTS: Fifteen studies, including 744 cases of HCC and 645 non-tumor cases, were identified for meta-analysis. Statistically significant odds ratios (ORs) of p16 hypermethylation were obtained from tumor tissues and non-tumorous liver tissues of HCC patients (OR 7.04, 95% CI: 3.87%-12.78%, P < 0.0001), tumor tissues of HCC patients and healthy liver tissues of patients with other diseases (OR 12.17, 95% CI: 6.64%-22.31%, P < 0.0001), tumor tissues of HCC patients and liver tissues of patients with non-tumorous liver diseases (OR 6.82, 95% CI: 4.31%-10.79%, P < 0.0001), and cirrhotic liver tissues and non-cirrhotic liver tissues (OR 4.96, 95% CI: 1.45%-16.96%, P = 0.01). The pooled analysis showed significantly increased ORs of p16 hypermethylation (OR 6.98, 95% CI: 4.64%-10.49%, P < 0.001) from HCC tissues and cirrhotic tissues.

CONCLUSION: P16 hypermethylation induces the inactivation of p16 gene, plays an important role in hepatocarcinogenesis, and is associated with an increased risk of HCC and liver cirrhosis.

Keywords: P16 hypermethylation; Hepatocellular carcinoma; Liver cirrhosis; Meta-analysis; Odds ratio