Research Papers:

A meta-analysis of MSI frequency and race in colorectal cancer

Hassan Ashktorab, Sadhna Ahuja, Lakshmi Kannan, Xavier Llor, Nathan A. Ellis, Rosa M. Xicola, Adeyinka O. Laiyemo, John M. Carethers, Hassan Brim _ and Mehdi Nouraie

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Oncotarget. 2016; 7:34546-34557. https://doi.org/10.18632/oncotarget.8945

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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

Correspondence to:

Hassan Ashktorab, email: [email protected]

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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