Document Type : Systematic Review and Meta-analysis
Authors
1
Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2
Department of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3
Department of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4
Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
5
Department of Anesthesiology and Critical Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
6
Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
7
Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abstract
Background: A number of case-control studies were conducted to investigate the association of angiotensin
converting enzyme insertion/deletion (ACE I/D) polymorphism with breast cancer. But the results remain controversial.
This meta-analysis aims to comprehensively evaluate the association of ACE I/D polymorphism with breast cancer.
Method: A comprehensive literature search on PubMed, Google Scholar, SCOPUS and ISI Web of Knowledge
databases for studies published up to June 01, 2018 was performed. Summary odds ratios (ORs) and 95% confidence
intervals (CI) were estimated. Publication bias of literatures was evaluated using funnel plots and Egger’s test. Results:
A total of 20 studies including 2846 breast cancer cases 9299 controls meeting the predefined criteria were involved in
the meta-analysis. Overall, the ACE I/D polymorphisms was significantly associated with breast cancer under the allele
model (I vs. D: OR= 0.803, 95% CI 0.647-0.996, p=0.046), the homozygote model (II vs. DD: OR= 0.662, 95% CI
0.462-0.947, p=0.024), the heterozygote model (ID vs. DD: OR= 0.707, 95% CI 0.528-0.946, p=0.020), the dominant
model (II+ID vs. DD: OR= 0.691, 95% CI 0.507-0.941, p=0.019). In the subgroup analysis by ethnicity, a significant
association was found among Asian and Caucasian populations, but not among mixed populations. Conclusions: This
meta-analysis suggests that ACE I/D polymorphism may be associated with increased risk of breast cancer, especially
among Asian and Caucasians. However, well-designed studies with larger sample size and more ethnic groups are
needed to further validate the results.
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