Abstract
INTRODUCTION: Survivin (BIRC5) is an anti-apoptosis protein over expressed in most cancers and associated with poor clinical outcomes. We have provided an updated meta-analysis of -31G/C (rs9904341) gene polymorphism which is highly associated with cancer risk. METHODOLOGY: A comprehensive literature search in PubMed and Google Scholar databases was conducted. A total of 10472 cases and 12193 controls from 51 studies were included in this meta-analysis. This study was prospectively registered in PROSPERO, and sensitivity analysis, risk of bias analysis, and statistical analysis were performed. A pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to assess the strength of the association. All analyses were achieved using RevMan 5.4 software and Excel 2013 version. RESULTS: The overall meta-analysis indicates that survivin gene polymorphism -31G/C (rs9904341) is highly associated with overall cancer risk in allelic (C vs. G, OR=1.25,95% CI= 1.15 to 1.37, P<0.00001), homozygous co-dominant (CC vs. GG, OR=1.53, 95% CI= 1.23 to 1.90, P=0.0001), heterozygous co-dominant (CC vs. CG, OR= 1.34, 95% CI= 1.18 to 1.52, P<0.00001), dominant model(CC+CG vs. GG, OR= 1.29, 95% CI= 1.14 to 1.46, P= <0.0001) and recessive model (CG+GG vs. CC, OR= 0.70, 95% CI= 0.61 to 0.81, P<0.00001). The stratified analysis revealed that the variant significantly increases the risk in the Asian population. CONCLUSION: -31G/C (rs9904341) polymorphism of the BIRC5 gene is associated with the risk of cancer in the Asian population. However, further large-scale clinical studies are required to re-evaluate this result in the future.