饮水砷暴露人群谷胱甘肽转移酶M1基因多态性和肿瘤及癌前病变关系的Meta分析

Meta-analysis of the Association of GSTM1 Gene Polymorphism with Risk of Cancer and Precancerous Lesions among Population Exposed to Arsenic from Drinking Water

目的探讨饮水砷暴露人群谷胱甘肽转移酶M1(GSTM1)基因多态性和肿瘤及癌前病变危险因素的关系,以期为肿瘤的基础和临床研究提供循证依据。方法通过计算机检索有关饮水砷暴露人群GSTM1基因多态性和肿瘤及癌前病变相关研究文献,严格按照纳入和排除标准,对检索到的符合标准的5篇文献进行Meta分析,对数据进行异质性检验,最后选择固定或随机效应模型进行统计学处理,根据数据结果进行分析,绘制漏斗图并评价发表偏倚对结果的影响程度。结果经过数据汇总分析,饮水砷暴露人群GSTM1基因空白缺失型和GSTM1野生基因携带型的比较,异质性检验P>0.05,实验选用固定效应模型,平均优势比为1.05,其95%CI(0.91,1.20),合并后的Z值为0.527,差异无统计学意义(P>0.05)。亚组分析中,恶性肿瘤组OR值为1.18〔95%CI(0.97,1.42)〕,皮肤癌前病变组合并OR值为0.91〔95%CI(0.74,1.12)〕,结果均无统计学意义(P>0.05)。结论饮水砷暴露人群GSTM1基因空白缺失型和肿瘤及癌前病变的发病风险无相关性。

Objective To investigate the association of GSTM1 gene polymorphism with the risk of cancer as well as precancerous lesions among population exposed to arsenic from drinking water.Methods Five independent studies on this topic were selected for meta-analysis.Fixed or random effect models were selected for statistical analysis based on the results of heterogeneity test.Also,a funnel plot was drawn for evaluating the publication biases.Results The pooled data analysis showed that the results of heterogeneity test was negative when comparing the GSTM1 null genotype group with the GSTM1 positive genotype group（P0.05）.The fixed effect model was applied.The pooled odds ratio was 1.05（95%CI（0.91,1.20）） and the pooled Z value was 0.527（P0.05）.Subgroup analyses showed that the GSTM1 gene polymorphism was not significantly associated with the cancer（OR=0.91,95%CI（0.74,1.12）） or precancerous lesions（OR=0.91,95%CI（0.74,1.12））.Conclusion GSTM1 null genotype may be not correlated with cancer and precancerous lesions among populations exposed to arsenic from drinking water.