Abstract
The polymorphism rs2853669 in the telomerase reverse transcriptase gene (TERT) promoter region is widely investigated for the risk of different cancers. However, previous results remained inconclusive. Thus, we performed this updated meta-analysis to comprehensively evaluate the association between rs2853669 and the susceptibility of human cancer. A systematic literature search via PubMed, EMBASE, Cochrane Library, and Web of Science databases was conducted that produced a total of 19 eligible studies containing 23,085 subjects. The relationship was calculated with the odds ratio (OR) and 95% confidence intervals (CIs). Statistical analyses were performed using the RevMan 5.4 software. The analysis indicated that rs2853669 is associated with an enhanced risk of overall cancer risk. From subgroup analysis, a significantly increased association in five genetic models (p < 0.05) was found among Asians, but no association was observed in Caucasians. Although we did not find any significant correlation between rs2853669 and breast cancer, an increased and statistically significant association was found for both lung cancer and acute myeloid leukemia. We did not find any association in other cancer types during stratified analysis. Our meta-analysis suggests that rs2853669 polymorphism in TERT gene is associated with an increased risk of overall cancer susceptibility, particularly in the Asian population. Moreover, rs2853669 is significantly associated with lung cancer and acute myeloid lymphoma. However, large-scale studies are needed to confirm our findings.
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References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.
Global Cancer Observatory (GCO). Available on https://gco.iarc.fr/tomorrow/home. Accessed on 29 Nov 2020
Xie Y, Zhu J, Fu Y, Guo X, Huang J, Liu Z. The association between TERT rs2853677 (A>G) and cancer risk: a meta-analysis. Int J Clin Exp Med. 2020;13(3):1323–33.
Li H, Xu Y, Mei H, Peng L, Li X, Tang J. The TERT rs2736100 polymorphism increases cancer risk: a meta-analysis. Oncotarget. 2017;8(24):38693–705. https://doi.org/10.18632/oncotarget.16309.
Jannuzzi AT, Karaman E, Oztas E, Yanar HT, Özhan G. Telomerase reverse transcriptase (TERT) gene variations and susceptibility of colorectal cancer. Genet Test Mol Biomarkers. 2015;19(12):692–7. https://doi.org/10.1089/gtmb.2015.0150.
Mimouni A, Rouleau E, Saulnier P, Marouani A, Abdelali ML, Filali T, Beddar L, Lakehal A, Hireche A, Boudersa A, et al. Association of TERT, OGG1, and CHRNA5 polymorphisms and the predisposition to lung cancer in Eastern Algeria. Pulm Med. 2020;7649038:12. https://doi.org/10.1155/2020/7649038.
Varadi V, Brendle A, Grzybowska E, Johansson R, Enquist K, Butkiewicz D, Pamula-Pilat J, Pekala W, Hemminki K, Lenner P, et al. A functional promoter polymorphism in the TERT gene does not affect inherited susceptibility to breast cancer. Cancer Genet Cytogenet. 2009;190(2):71–4. https://doi.org/10.1016/j.cancergencyto.2008.12.006.
Li X, Xu X, Fang J, Wang L, Mu Y, Zhang P, Yao Z, Ma Z, Liu Z. Rs2853677 modulates Snail1 binding to the TERT enhancer and affects lung adenocarcinoma susceptibility. Oncotarget. 2016;7(25):37825–38. https://doi.org/10.18632/oncotarget.9339.
Campa D, Rizzato C, Stolzenberg-Solomon R, Pacetti P, Vodicka P, Cleary SP, Capurso G, Bueno-de-Mesquita HB, Werner J, Gazouli M, et al. TERT gene harbors multiple variants associated with pancreatic cancer susceptibility. Int J Cancer. 2015;137(9):2175–83. https://doi.org/10.1002/ijc.29590.
Colebatch AJ, Dobrovic A, Cooper WA. TERT gene: its function and dysregulation in cancer. J Clin Pathol. 2019;72(4):281–4. https://doi.org/10.1136/jclinpath-2018-205653.
Yilmaz I, Erkul BE, Ozturk Sari S, Issin G, Tural E, Terzi Kaya Terzi N, Karatay H, Celik M, Ulusan M, Bilgic B. Promoter region mutations of the telomerase reverse transcriptase (TERT) gene in head and neck squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;130(1):63–70. https://doi.org/10.1016/j.oooo.2020.02.015.
Batista R, Lima L, Vinagre J, Pinto V, Lyra J, Máximo V, Santos L, Soares P. TERT promoter mutation as a potential predictive biomarker in BCG-treated bladder cancer patients. Int J Mol Sci. 2020;21(3):947. https://doi.org/10.3390/ijms21030947.
Yuan P, Huang S, Bao FC, Cao JL, Sheng HX, Shi L, Lv W, Hu J. Discriminating association of a common telomerase reverse transcriptase promoter polymorphism with telomere parameters in non-small cell lung cancer with or without epidermal growth factor receptor mutation. Eur J Cancer. 2019;120:10–9. https://doi.org/10.1016/j.ejca.2019.06.024.
Shen N, Lu Y, Wang X, Peng J, Zhu Y, Cheng L. Association between rs2853669 in TERT gene and the risk and prognosis of human cancer: a systematic review and meta-analysis. Oncotarget. 2017;8(31):50864–72. https://doi.org/10.18632/oncotarget.15140.
Liu Z, Wang T, Wu Z, Zhang K, Li W, Yang J, Chen C, Chen L, Xing J. Association between TERT rs2853669 polymorphism and cancer risk: a meta-analysis of 9,157 cases and 11,073 controls. PLoS ONE. 2018;13(3):e0191560. https://doi.org/10.1371/journal.pone.0191560.
Killela PJ, Reitman ZJ, Jiao Y, Bettegowda C, Agrawal N, Diaz LA Jr, Friedman AH, Friedman H, Gallia GL, Giovanella BC, et al. TERT promoter mutations occur frequently in gliomas and a subset of tumors derived from cells with low rates of self-renewal. Proc Natl Acad Sci USA. 2013;110(15):6021–6. https://doi.org/10.1073/pnas.1303607110.
Xing YL, Liu F, Li JF, Lin JC, Zhu GD, Li M, Zhang CR, Niu YY. Case–control study on impact of the telomerase reverse transcriptase gene polymorphism and additional single nucleotide polymorphism (SNP)–SNP interaction on non-small cell lung cancers risk in Chinese Han population. J Clin Lab Anal. 2016;30(6):1071–7. https://doi.org/10.1002/jcla.21982.
Yoo SS, Do SK, Choi JE, Lee SY, Lee J, Cha SI, Kim CH, Park JY. TERT polymorphism rs2853669 influences on lung cancer risk in the Korean population. J Korean Med Sci. 2015;30:1423–8. https://doi.org/10.3346/jkms.2015.30.10.1423.
Zhong R, Liu L, Zou L, Zhu Y, Chen W, Zhu B, Shen N, Rui R, Long L, Ke J, et al. Genetic variations in TERT-CLPTM1L locus are associated with risk of lung cancer in Chinese population. Mol Carcinog. 2013;52:E118–26. https://doi.org/10.1002/mc.22043.
Oztas E, Kara H, Kara ZP, Aydogan MU, Uras C, Ozhan G. Association between human telomerase reverse transcriptase gene variations and risk of developing breast cancer. Genet Test Mol Biomarkers. 2016;20(8):459–64. https://doi.org/10.1089/gtmb.2015.0339.
Shen J, Gammon MD, Wu HC, Terry MB, Wang Q, Bradshaw PT, Teitelbaum SL, Neugut AI, Santella RM. Multiple genetic variants in telomere pathway genes and breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2010;19(1):219–28. https://doi.org/10.1158/1055-9965.EPI-09-0771.
Savage SA, Chanock SJ, Lissowska J, Brinton LA, Richesson D, Peplonska B, Bardin-Mikolajczak A, Zatonski W, Szeszenia-Dabrowska N, Garcia-Closas M. Genetic variation in five genes important in telomere biology and risk for breast cancer. Br J Cancer. 2007;97:832–6. https://doi.org/10.1038/sj.bjc.6603934.
Tong Y, Xiang Y, Li B, Bao S, Zhou Y, Yuan W, Ling Y, Hao D, Zhu H, Sun Z. Association between TERT gene polymorphisms and acute myeloid leukemia susceptibility in a Chinese population: a case–control study. Cancer Cell Int. 2020;16(20):313. https://doi.org/10.1186/s12935-020-01335-3.
Mosrati MA, Willander K, Falk IJ, Hermanson M, Hoglund M, Stockelberg D, Wei Y, Lotfi K, Soderkvist P. Association between TERT promoter polymorphisms and acute myeloid leukemia risk and prognosis. Oncotarget. 2015;6:25109–20. https://doi.org/10.18632/oncotarget.4668.
Vinothkumar V, Arun K, Arunkumar G, Revathidevi S, Ramani R, Bhaskar LVKS, Murugan AK, Munirajan AK. Association between functional TERT promoter polymorphism rs2853669 and cervical cancer risk in South Indian women. Mol Clin Oncol. 2020;12(5):485–94. https://doi.org/10.3892/mco.2020.2003.
Zhang Y, Zhang X, Zhang H, Zhai Y, Wang Z, Li P, Yu L, Xia X, Zhang Y, Zeng Y, et al. Common variations in TERT-CLPTM1L locus are reproducibly associated with the risk of nasopharyngeal carcinoma in Chinese populations. Oncotarget. 2016;7(1):759–70. https://doi.org/10.18632/oncotarget.6397.
Liu Z, Ma H, Wei S, Li G, Sturgis EM, Wei Q. Telomere length and TERT functional polymorphisms are not associated with risk of squamous cell carcinoma of the head and neck. Cancer Epidemiol Biomarkers Prev. 2011;20(12):2642–5. https://doi.org/10.1158/1055-9965.EPI-11-0890.
Shadrina AS, Boyarskikh UA, Oskina NA, Sinkina TV, Lazarev AF, Petrova VD, Filipenko ML. TERT polymorphisms rs2853669 and rs7726159 influence on prostate cancer risk in Russian population. Tumour Biol. 2015;36:841–7. https://doi.org/10.1007/s13277-014-2688-0.
Bayram S, Ülger Y, Sümbül AT, Kaya BY, Genç A, Rencüzoğullari E, Dadaş E. Polymorphisms in human telomerase reverse transcriptase (hTERT) gene and susceptibility to gastric cancer in a Turkish population: Hospital-based case–control study. Gene. 2016;585(1):84–92. https://doi.org/10.1016/j.gene.2016.03.030.
Mosrati MA, Malmstrom A, Lysiak M, Krysztofiak A, Hallbeck M, Milos P, Hallbeck AL, Bratthall C, Strandeus M, Stenmark-Askmalm M, et al. TERT promoter mutations and polymorphisms as prognostic factors in primary glioblastoma. Oncotarget. 2015;6:16663–73. https://doi.org/10.18632/oncotarget.4389.
Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2014.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–41. https://doi.org/10.1016/j.ijsu.2010.02.007.
Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4):1088–101.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34. https://doi.org/10.1136/bmj.315.7109.629.
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The authors are thankful to the Department of Pharmacy, Noakhali Science and Technology University for their support while conducting this study.
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MSI: Conceptualization, Supervision, Data analysis, Software; MAA and SJ: Literature search; MAA: Writing—Original draft preparation, Methodology; MSI: Writing—Reviewing and Editing.
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Aziz, M.A., Jafrin, S. & Islam, M.S. Human TERT promoter polymorphism rs2853669 is associated with cancers: an updated meta-analysis. Human Cell 34, 1066–1081 (2021). https://doi.org/10.1007/s13577-021-00520-4
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DOI: https://doi.org/10.1007/s13577-021-00520-4