Abstract. The mouse double minute 2 (MDM2) gene is an important regulator of the p53 suppressor gene. To date, evidence concerning the association of the MDM2 single nucleotide polymorphism (SNP) 309T>G (rs2279744) with the risk of developing oral squamous cell carcinoma (OSCC) remains controversial. Therefore, a meta-analysis of all the eligible studies was performed, in order to derive a more precise estimation of this association. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the degree of association in 5 previous studies, including a total of 1,369 OSCC cases and 2,167 controls. The overall analysis revealed a significant association between MDM2 SNP309 and OSCC risk in the heterozygote (TG vs. TT: OR=0.81; 95% CI: 0.68-0.96; P=0.02) and dominant models (TG+GG vs. TT: OR=0.82; 95% CI: 0.69-0.97; P=0.02). The subgroup analysis based on the source of the controls revealed a significant association between population-based controls and the heterozygote model (TG vs. TT: OR=0.75; 95% CI: 0.62-0.91; P=0.004), dominant model (TG+GG vs. TT: OR=0.76; 95% CI: 0.63-0.91; P=0.003) and allele comparison (G vs. T: OR=0.89; 95% CI: 0.79-0.99; P=0.04). Importantly, no evidence of publication bias or obvious heterogeneity were observed in the meta-analysis. The results of the present study demonstrated a decreased risk of developing OSCC for the MDM2 SNP309 group, suggesting MDM2 SNP309 may be a protection-associated genetic variation for OSCC. Additional well-designed studies, with larger sample sizes, are required to further elucidate this association.
IntroductionOral cancer is one of the most common cancers worldwide, with an unclear pathogenesis; the oral squamous cell carcinoma (OSCC) subtype accounts for >90% of all oral cancers (1). While increasing evidence suggests that environmental factors, as well as chemical carcinogens (including tobacco and alcohol) are likely etiological factors that contribute to the development of OSCC, only a small minority of individuals exposed to these carcinogens will subsequently develop head and neck SCC (2,3). Oral carcinogenesis is widely recognized as a stepwise process, and the involvement of genetic alterations and host polymorphisms may be important to its development (4). The identification of a predictive model of risk polymorphisms may facilitate early diagnosis and the understanding of disease progression in a subset of cancer patients (4).The human mouse double minute 2 (MDM2) gene is an important negative regulator of the p53 suppressor gene, promoting the degradation of p53 through its E3 ubiquitin ligase activity (5). A functional single-nucleotide polymorphism (SNP), rs2279744, is located at nucleotide 309 in the first intron of the MDM2 promoter region, consisting of a change from T to G. This mutation has been named SNP309 (6). SNP 309T>G is known to enhance the binding affinity of the transcriptional activator SP1, contributing to increased expression of MDM2 and subsequent attenuation of the p53 tumor suppressor pathway (6). MDM2 SNP3...