The hMLH1 gene is a key member of DNA damage repair genes. The studies on the relationship between hMLH1 promoter methylation and gastric cancer are frequently appearing in East Asians. However, the exact conclusion is not clear. To better understand the association between gastric cancer and hMLH1 promoter methylation, we performed a comprehensive meta-analysis. Methods: We conducted a meta-analysis by systematically reviewing the related articles which were published in English or Chinese and

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... concerned on hMLH1 promoter methylation and gastric cancer in East Asians. Finally 17 studies with 1943 cases and 1575 controls were included in this meta-analysis. Odds ratios and their 95% confidence intervals were used to reveal the quantitative relationship between gastric cancer and hMLH1 promoter methylation. Results: A strong significant association was observed between hMLH1 promoter methylation and gastric cancer. The frequencies of hMLH1 promoter methylation in gastric cancer tissues were higher than those of adjacent normal tissues (OR=15.73, 95% CI=8.05-30.75) and cancer-free subjects (OR=19.03, 95% CI=7.83-46.23). In addition, we observed significant association of hMLH1 promoter methylation with age, gender, histological differentiation and lymph node metastasis (age: OR=0.53, 95% CI=0.36-0.79; gender: OR=0.71, 95% CI=0.52-0.96; histological differentiation: OR=2.26, 95% CI=1.06-4.81; lymph node metastasis: OR=0.59, 95% CI=0.39-0.88), but no association of hMLH1 promoter methylation status with peritoneal or distant metastasis and Helicobacter pylori infection (peritoneal or distant metastasis: OR=0.56, 95% CI=0.28-1.15; Helicobacter pylori infection: OR=2.02, 95% CI=0.96-4.25). Conclusion: Our investigations demonstrated that strong associations exist between hMLH1 gene methylation and gastric cancer in populations of East Asia.