Association between APC Promoter Methylation and Lung Cancer: A Meta-analysis

Objective To assess the association between adenornatous polyposis coil(APC) promoter methylation and lung cancer and the possibility of identifying early-stage lung cancer, and to provide the basis for the diagnosis of lung cancer.

Methods Literature search for studies on association between APC promoter methylation and lung cancer published up to February 7, 2020 was conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WanFang Med Online, and VIP database. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, studies were selected based on the prespecified inclusion and exclusion criteria, and subjected to methodological quality assessment and data extraction. Stata 15 and R 3.6.1 were used for statistical analysis.

Results A total of 12 case-control studies from 10 publications were included, involving 1190 cases and 606 controls. According to heterogeneity test (I²=58%), a random effect model was used to merge the pooled effect, and the odds ratio (OR) was 9.84 (95% CI: 5.03-19.27, P < 0.05), which indicates that the risk of lung cancer in population with APC promoter methylation was 9.84 times higher than that in general population. Subgroup analysis showed a significant association between APC promoter methylation and lung cancer in tissue (OR=5.24, 95% CI: 1.06-25.92), blood (OR=9.58, 95% CI: 5.98-15.35), and sputum (OR=36.59, 95% CI: 4.86-275.36). Moreover, the risk of lung cancer with APC promoter methylation was significantly related to the proportion of lung adenocarcinoma and age (P < 0.05), but not to clinical stage (P>0.05).

Conclusion APC promoter methylation may be a potential biomarker for lung cancer diagnosis.