CTLA-4+49A/G基因多态性与结直肠癌易感性的荟萃分析

CTLA-4+49A/G polymorphism and colorectal cancer risk: a meta-analysis

目的探讨细胞毒性T淋巴细胞相关抗原4（CTLA-4）外显子上49位点基因多态性与结直肠癌易感性的关系。方法通过计算机检索和手工检索,收集CTLA-4＋49A/G基因多态性与结直肠癌易感性关系的病例-对照研究,筛选出符合条件的文献,应用荟萃（meta）分析软件对各项研究进行异质性检验,计算合并OR值及其95%可信区间（CI）,并进行发表偏移的评估。结果国内外共有7篇文献纳入研究（结直肠癌患者1 084例,对照组1 934例）;meta分析结果显示,CTLA-4＋49A/G基因多态性在全部人群中与结直肠癌有相关性：显性遗传模型（AG＋GG vs AA：OR=1.81,95%CI=1.17~2.81,P〈0.05）;隐性遗传模型总体无统计学意义（P〉0.05）。人群分层分析发现,CTLA-4＋49A/G基因多态性与结直肠癌易感性在亚洲人群中有相关性：显性遗传模型（AG＋GG vs AA：OR=2.42,95%CI=1.40~4.16,P〈0.05）;隐性遗传模型总体无统计学意义（P〉0.05）。但与欧洲人群结直肠癌易感性无明显相关：显性遗传模型（AG＋GG vs AA：OR=0.93,95%CI=0.65~1.33,P〉0.05）;隐性遗传模型无统计学意义（P〉0.05）。结论 CTLA-4＋49A/G基因多态性与结直肠癌易感性相关,但主要表现在亚洲人群。

Objective To investigate the correlation between cytotoxic T lymphocyte-associated antigen-4 （CTLA-4） exon ＋ 49A/G polymorphism and susceptibility of colorectal cancer. Methods The case-control studies on correlation between CTLA-4 ＋ 49A/G polymorphism and colorectal cancer risk were searched by computer and manual method. The literatures according with selection standard were analyzed by Revman 5.2 software, and the pools ORs with 95% CI were calculated. Publication bias was also evaluated. Results A total of 7 case-control studies including 1 084 colorectal cancer patients and 1 934 controls were included in this study. The pooled results showed that the CTLA-4 ＋ 49A/G polymorphism was related to colorectal cancer risk, which was mainly presented in dominant inheritance（ AG ＋ GG vs AA： OR = 1.81, 95% CI = 1.17-2.81, P 〈 0.05） but not in recessive heredity（P 〉 0.05）. The subgroup analysis for population showed that there was correlation between CTI_A-4 ＋49A/G polymorphism and colorectal cancer risk in Asian population, which was also presented in dominant inheritance（ AG ＋ GG vs AA ： OR = 2.42, 95% CI = 1.40-4.16, P 〈 0.05 ） but not in recessive heredity（P 〉0.05 ）. However, there was no correlation between CTLA-4 ＋ 49A/G polymorphism and eolorectal cancer risk in European population（dominant inheritance： AG ＋ GG vs AA： OR = 0.93, 95% C1 = 0.65-1.33, P 〉 0.05, recessive heredity： P 〉 0.05 ）. Conclusion CTLA--4 ＋ 49A/G polymorphism may mainly associate with increased risk of eolorectal cancer in Asian population.