Association between the APEX1 Asp148Glu polymorphism and prostate cancer, especially among Asians: a new evidence-based analysis

Background: Prostate cancer (Pca) is a serious disease associated with considerable morbidity and mortality. As a causative factor, the Asp148Glu polymorphism has been identified in the apurinic/apyrimidinic endonuclease (APEX1) gene. However, the association among Asians is considered controversial. Methods: Evidence for this association was obtained from the PubMed, Embase, HuGENet and Chinese National Knowledge Infrastructure (CNKI) databases. In the analysis, four models were applied. Associations between the APEX1 polymorphism and the invasiveness of Pca based on the Gleason score, prostate-specific antigen expression and clinical status were also evaluated. Results: Seven articles were included in the analysis. Positive results were not only discovered in the pooled analysis, but also among patients of mixed descent and Asian descent. However, after considering the Hardy-Weinberg equilibrium (HWE), we observed only a 1.557-fold increase in Pca risk for subjects of Asian descent (GG vs. TT: OR=1.557, 95% CI=1.069-2.268) under the co-dominant model. Additionally, we did not also find any relationship between the APEX1 Asp148Glu polymorphism and invasive Pca risk. Conclusion: On the basis of the function of the APEX1 Asp148Glu polymorphism, recent studies, and our results, we suggest that the APEX1 Asp148Glu polymorphism might be important in stimulating the development of Pca rather than its invasiveness in various populations, especially for Asians.