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Meta-Analysis
. 2015 Apr 13:4:46.
doi: 10.1186/s13643-015-0037-z.

The Epstein-Barr virus latent membrane protein-1 (LMP1) 30-bp deletion and XhoI-polymorphism in nasopharyngeal carcinoma: a meta-analysis of observational studies

Vivaldo G da Costa  1   2 , Ariany C Marques-Silva  3 , Marcos L Moreli  4   5
Affiliations
Meta-Analysis

The Epstein-Barr virus latent membrane protein-1 (LMP1) 30-bp deletion and XhoI-polymorphism in nasopharyngeal carcinoma: a meta-analysis of observational studies

Vivaldo G da Costa et al. Syst Rev. .

Abstract

Background: Epstein-Barr virus (EBV) is considered to be closely associated with nasopharyngeal carcinoma (NPC), in which EBV-encoded latent membrane protein 1 (LMP1) was found to have an oncogenic role. However, the results published on the LMP1 polymorphism are inconsistent. In the present study, we performed a meta-analysis to determine the frequency of the associations and a more precise association between NPC and EBV LMP1 gene variants (30-bp deletion (del)/XhoI-loss).

Methods: Eligible articles met the inclusion/exclusion criteria and were identified in the following electronic databases: PubMed, ScienceDirect, and SciELO. Consequently, the data of interest were extracted and plotted in a table to calculate the frequency and odds ratio (OR) of the outcomes of interest (30-bp del-LMP1/XhoI-loss) in patients with NPC. Study quality (Newcastle-Ottawa Scale (NOS)), publication bias, and heterogeneity were assessed.

Results: Thirty-one observational studies were included with a total of 2,846 individuals (NPC, n = 1,855; control, n = 991). The risk of bias in relation to study quality evaluated by NOS was considered low. The pooled estimate of the frequency of 30-bp del-LMP1 and XhoI-loss in patients with NPC was 77% (95% confidence interval (CI): 72 to 82) and 82% (95% CI: 71 to 92), respectively. There was an association between 30-bp del-LMP1 and NPC susceptibility (OR = 2.86, 95% CI: 1.35 to 6.07, P = 0.00). Similarly, there was an association between XhoI-loss and NPC (OR = 8.5, 95% CI: 1.7 to 41, P = 0.00). However, when we analyze the co-existence of the 30-bp del-LMP1 and XhoI-loss in patients with NPC, there was no association (OR = 1.09, 95% CI: 0.06 to 18.79, P = 0.002).

Conclusions: Our results suggest an association between the 30-bp del-LMP1 and XhoI-loss with NPC susceptibility. However, our data should be interpreted with caution because the sample size was small, and there was heterogeneity between the studies. Thus, future studies are needed with adjusted estimates to simultaneously evaluate multiple factors involved in the development of NPC.

Systematic review registration: PROSPERO CRD42014013496 .

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Figures

Figure 1
Figure 1
Forest plot of the frequency of the occurrence of the two outcomes of interest in the patients with NPC. The confidence interval (CI) was 95%, and the diamond represents the pooled estimate. ID = identification of study.
Figure 2
Figure 2
Forest plot of the OR for the 30-bp del-LMP1 and XhoI-loss in NPC. The diamond represents the pooled OR and its 95% confidence intervals (CIs). ID = identification of study.
Figure 3
Figure 3
Forest plot of the odds ratio (OR) in relation to the origin from the studies for the outcome of the 30-bp del-LMP1 (A) and XhoI-loss (B) in patients with NPC. CI = confidence interval; ID = identification of study.
See this image and copyright information in PMC

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