Abstract
The genetics of cancer metastasis is important for designing optimal therapeutic strategies. The lysyl oxidase (LOX) gene has been found important in the metastatic process, with roles in setting the microenvironment for future metastatic sites. Associations between the LOX polymorphisms (473G/A and -22G/C) have been examined in several studies, however, results were inconsistent, prompting a meta-analysis in order to obtain more precise estimates.Searches of six databases yielded 14 articles (15 studies) that examined associations of 473G/A and -22G/C with cancer. We examined five cancer groups: breast, lung, bone (osteosarcoma), GIC (gastrointestinal cancers) and GYC (gynecological cancers). For each cancer group, we calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs) using standard genetic models. High significance (Pa < 0.00001), homogeneity (I2 = 0%) and high precision of effects (CI difference < 1.0 [upper CI-lower CI]) comprised the three criteria for strength of evidence (SOE). Multiple comparisons were Bonferroni-corrected. Sensitivity analysis assessed robustness of the outcomes.Thirteen significant associations indicating increased risk (OR > 1.00) were found in all cancer groups except breast (Pa = 0.10-0.91). Of the 13, two were in osteosarcoma where the -22G/C effects (ORs 4.05-4.07, 95% CIs 1.30-12.70, Pa = 0.02) were homogeneous (I2 = 0%) but imprecise (CIDs 11.4) and did not survive the Bonferroni correction. In contrast, the Bonferroni-surviving dominant/codominant outcomes in lung cancer (OR 1.44, 95% CI 1.19-1.74) and GYC (ORs 1.52-1.62, 95% CIs 1.26-1.88) met all three SOE criteria (Pa = 0.00001, I2 = 0%, CIDs 0.49-0.56).In summary, associations of LOX 473G/A with lung, ovarian and cervical cancers indicate 1.4-1.6-fold increased risks. These outcomes were underpinned by robustness and high statistical power at the aggregate level.