A meta-analysis of MSI frequency and race in colorectal cancer
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Hassan Ashktorab1, Sadhna Ahuja2, Lakshmi Kannan1, Xavier Llor3, Nathan A. Ellis4, Rosa M. Xicola3, Adeyinka O. Laiyemo1, John M. Carethers5, Hassan Brim2, Mehdi Nouraie1
1Department of Medicine and Cancer Center, Howard University College of Medicine, Washington DC, USA
2Department of Pathology, Howard University College of Medicine, Washington DC, USA
3Department of Medicine and Cancer Center, Yale University, New Haven, CT, USA
4Cancer Biology Research Program, The University of Arizona Cancer Center, Tucson, AZ, USA
5Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Hassan Ashktorab, email: firstname.lastname@example.org
Keywords: MSI, colorectal cancer, African Americans, Hispanics, Caucasians
Received: December 14, 2015 Accepted: March 28, 2016 Published: April 23, 2016
PURPOSE: African Americans (AA) are at a higher risk of colorectal cancer (CRC) and some studies report a higher frequency of microsatellite instability (MSI) in this population while others report lower frequency compared to Caucasians.
AIM: To determine and evaluate the association of race and clinical factors with MSI frequency through meta- analysis.
METHODS: Twenty-two studies out of 15,105 (1997-2015) were evaluated after a search in different literature databases, using keywords “colorectal cancer, microsatellite instability, African Americans, Caucasians and Hispanics”. We used random effect meta-analysis to calculate the MSI frequency in all studies as well as in African American and Caucasian samples. Meta-regression analysis was used to assess the univariate effect of race, gender, age, tumor location and stage on MSI frequency.
RESULTS: The overall MSI frequency among CRCs was 17% (95%CI: 15%-19%, I²=91%). In studies with available race data, The MSI rate among AAs, Hispanics and Caucasians were 12%, 12% and 14% respectively and was not significantly different. Sub-group analysis of studies with racial information indicates MSI OR of 0.78 for AAs compared to Caucasians.
CONCLUSION: CRCs demonstrate an overall MSI frequency of 17%. MSI frequency differences between AAs and Caucasians were not pronounced, suggesting that other factors contribute to the racial disparity. The methodological approaches and biological sources of the variation seen in MSI frequency between different studies need to be further investigated.
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