Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis.

BACKGROUND: Previous studies suggested that diabetes mellitus was associated with cancer risk and prognosis, but studies investigating the relationship between diabetes mellitus and survival in patients with hepatocellular carcinoma (HCC) reported inconsistent findings. To derive a more precise estimate of the prognostic role of diabetes mellitus in HCC, we systematically reviewed published studies and carried out a meta-analysis. METHODS: Eligible articles were identified in electronic databases from their inception through September 16, 2013. To evaluate the correlation between diabetes mellitus and prognosis in HCC, the pooled hazard ratios (HR) and their 95% confidence intervals (95% CI) for poorer overall and disease-free survivals were calculated by standard meta-analysis techniques with fixed-effects or random-effects models. RESULTS: 21 studies with a total of 9,767 HCC patients stratifying overall survival and/or disease-free survival in HCC patients by diabetes mellitus status were eligible for meta-analysis. 20 studies with a total of 9,727 HCC cases investigated the overall survival, and 10 studies with a total of 2,412 HCC patients investigated the disease-free survival. The pooled HRs for overall survival and disease-free survival were 1.46 (95% CI, 1.29 to 1.66; P<0.001) and 1.57 (95% CI, 1.21 to 2.05; P = 0.001), respectively. The adjusted HRs for overall survival and disease-free survival were 1.55 (95% CI, 1.27 to 1.91; P<0.001) and 2.15 (95% CI, 1.75 to 2.63; P<0.001), respectively. In addition, for patients receiving hepatic resection, diabetes mellitus was associated with both poorer overall survival and poorer disease-free survival, and for patients receiving non-surgical treatment or patients receiving radiofrequency ablation, diabetes mellitus was associated with poorer overall survival. There was no evidence for publication bias. CONCLUSION: Diabetes mellitus is independently associated with both poorer overall survival and poorer disease-free survival in HCC patients.

Significant associations between X-ray repair cross-complementing group 3 genetic polymorphisms and thyroid cancer risk.

Polymorphisms in X-ray cross-complementing group 3 (XRCC3) are proposed to be associated with cancer susceptibility, but previous studies on the associations between XRCC3 polymorphisms and thyroid cancer are controversial. We performed a systemic review and meta-analysis to investigate the associations of XRCC3 polymorphisms with thyroid cancer risk. We used odds ratio (OR) with 95 % confidence interval (95%CI) to assess the associations. For XRCC3 C241T polymorphism, meta-analysis of total eligible studies showed that there was no association between XRCC3 C241T polymorphism and thyroid cancer risk, but subgroup analysis in Caucasians showed that there was a significant association between XRCC3 C241T polymorphism and thyroid cancer risk (T versus C: OR = 1.30, 95%CI 1.05-1.62, P = 0.01; TT versus CC: OR = 1.74, 95%CI 1.13-2.70, P = 0.01; TT versus CC/CT: OR = 1.74, 95%CI 1.16-2.60, P = 0.007). For XRCC3 A17893G polymorphism, meta-analysis of total eligible studies showed that there was an obvious association between XRCC3 A17893G polymorphism and thyroid cancer risk (GG versus AA/AG: OR = 0.57, 95%CI 0.35-0.93, P = 0.02), but subgroup analysis by ethnicity only identify the significant association in Asians. In summary, the meta-analysis suggests that there are significant associations of XRCC3 polymorphisms with thyroid cancer risk. Besides, more studies with large sample sizes are needed to further assess the associations above.

Association between TP53 Arg72Pro polymorphism and thyroid carcinoma risk.

TP53 Arg72Pro polymorphism has been proposed to have some effects on host's susceptibility to cancer. Several studies were published to assess the association between TP53 Arg72Pro polymorphism and thyroid carcinoma, but they reported controversial results. We performed a systemic review and meta-analysis to assess the association between TP53 Arg72Pro polymorphism and thyroid carcinoma. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the association. Fourteen individual studies with 3,483 subjects were finally included into the meta-analysis. Overall, there was an obvious association between TP53 Arg72Pro polymorphism and thyroid carcinoma under the recessive model (ProPro vs. ArgArg/ArgPro, OR = 2.02, 95% CI 1.13 to 3.62, P = 0.02). Subgroup analysis by race showed that TP53 Arg72Pro polymorphism was associated with thyroid carcinoma in Caucasians (ProPro vs. ArgArg/ArgPro, OR = 2.31, 95% CI 1.08 to 4.93, P = 0.03). Subgroup analysis by histological type showed that TP53 Arg72Pro polymorphism was not associated with a risk of different types of thyroid carcinoma. In summary, the meta-analysis suggests that TP53 Arg72Pro polymorphism is associated with thyroid carcinoma risk in Caucasians. Besides, more studies with large sample size are needed to further assess the associations above.