O-6-Methylguanine-DNA methyltransferase expression is associated with pituitary adenoma tumor recurrence: a systematic meta-analysis.
O-6-methylguanine-DNA methyltransferase (MGMT) reportedly counteracts the cytotoxic effects of the alkylating agent temozolomide. MGMT expression is often low in aggressive pituitary adenomas (PAs) and recurrent PAs. However, because these associations are controversial, we performed this meta-analysis to clarify the involvement of MGMT in the prognosis and clinicopathology of PA. We searched for relevant studies in electronic databases (MEDLINE, the Cochrane Library Database, EMBASE, CINAHL, Web of Science and the Chinese Biomedical Database (CBD)) and calculated/pooled the odds ratios (ORs) or standard mean differences (SMDs) with 95% confidence intervals (95% CIs). Eleven case-control studies with a total of 454 PA patients were included. Our meta-analysis revealed that lower expression of MGMT was associated with PA recurrence (OR=2.09, 95% CI=1.09-4.02; p=0.026). On the other hand, MGMT expression was not associated with PA invasiveness (OR=1.112, 95% CI=0.706-1.753; p=0.646), Unexpectedly, MGMT expression could not be used to distinguish functional from non-functional PA patients (OR=1.766, 95% CI=0.938-3.324; p=0.078). The MGMT expression was not found to be related to other clinicopathological indicators of PA including age, gender or tumor size. No publication bias was detected in this meta-analysis (p>0.05). This meta-analysis suggests that MGMT expression may be associated with PA tumor recurrence, but not be related to invasiveness or other clinicopathological indicators. Thus, detection of MGMT expression may facilitate outcome prediction and guide clinical therapy for PA patients.
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Congxin
C
Dai
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Bowen
B
Sun
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Xiaohai
X
Liu
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Xinjie
X
Bao
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Ming
M
Feng
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Yong
Y
Yao
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Junji
J
Wei
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Kan
K
Deng
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Chengxian
C
Yang
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Xueyuan
X
Li
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Wenbin
W
Ma
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Renzhi
R
Wang
D000236:Adenoma / Q000201:enzymology / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016022:Case-Control Studies; D015254:DNA Modification Methylases / Q000378:metabolism*; D045643:DNA Repair Enzymes / Q000378:metabolism*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000201:enzymology; D010911:Pituitary Neoplasms / Q000201:enzymology / Q000473:pathology*; D011379:Prognosis; D025521:Tumor Suppressor Proteins / Q000378:metabolism*
D014408:Biomarkers, Tumor; D025521:Tumor Suppressor Proteins; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes
MGMT; aggressive; pituitary adenomas; recurrence