中国人群细胞色素P450 2E1(CYP 2E1)基因多态性与胃癌易感性的Meta分析

Meta-analysis on association between genetic polymorphisms of cytochrome P450 2E1 and susceptibility to Chinese gastric cancer

目的分析中国人群细胞色素P450 2E1(CYP 2E1)基因多态性与胃癌发病风险之间的关系。方法以中英文"细胞色素P450 2E1"、"细胞色素P450"、"CYP 2E1"、"胃癌"、"胃肿瘤"、"个体易感性"、"基因多态性"、"危险因素"为检索词,采用主题词与关键词相结合的方式,检索Pub Med、Embase、中国生物医学文献数据库、维普中文科技期刊数据库(VIP)、国家知识基础设施(CNKI)中国期刊全文数据库(Web版)、万方数据库中发表于1997年1月1日至2016年12月31日的以中国人群为研究对象的文献。对原始文献研究质量评分大于6星的文献利用Stata14.0进行Meta分析。结果经筛选可纳入本次Meta分析的研究共10篇,覆盖我国胃癌高、中、低发区,累计病例832例,对照1018例;纳入研究的群体符合哈代-温伯格(HWE)定律;具有CYP 2E1 C1C2基因型的人群比具有CYP 2E1 C1C1基因型的人群胃癌发病风险低,差异具有统计学意义(OR=0.650,P<0.001,95%CI0.515~0.821);依据样本量进行亚组分析,样本量较小的原始研究显示具有CYP2E1 C1C1基因型的人群的患胃癌风险是具有CYP 2E1 C1C2与C2C2基因型人群的2.02倍(P<0.001,95%CI 1.55~2.64),样本量较大的原始研究显示具有CYP 2E1C1C1基因型的人群发生胃癌风险是具有CYP 2E1 C1C2基因型与C2C2基因型人群患胃癌风险的0.93倍(P=0.586,95%CI 0.71~1.22),总体合并OR值为1.50(P=0.006,95%CI 1.12~2.00),表示具有CYP 2E1 C1C1基因型的人群发生胃癌风险是具有CYP 2E1 C1C2基因型与C2C2基因型人群患胃癌风险的1.50倍。结论样本量的大小是影响结果的重要因素,小样本量的研究倾向得到阳性的结果,具有CYP2E1 C1C1基因型的人群是否为胃癌的危险因素有待进一步研究。

Objective To conduct a comprehensive quantitative analysis about the association between genetic polymorphisms of CYP 2E1 and susceptibility to Chinese gastric cancer in order to offer evidence-based evidence for the etiology of gastric cancer.Methods Using the keywords and entry terms of cytochrom P450 2E1,cytochrome P450,CYP 2E1,stomach neoplasms,individual susceptibility,gene polymorphism,risk factors in English and Chinese, we searched medical literature databases, such as Pub Med,Embase,CBM,VIP,CNKI,China Info,published from January 1 th,1997 to December 31 th,2016,the Chines population was selected as the research object. Metaanalysis was performed using Stata 14. 0 in literature that selected quality studies of original literatures of more than 6 stars. Results There were 10 high-quality original articles covering high,middle and low incidence areas of gastric cancer in our country,with 832 cases and 1018 controls were included,which fit the HWE test. The population with CYP 2E1 C1C2 genotype have a lower risk of developing gastric cancer than the population with CYP 2E1 C1C1 genotype（ OR = 0. 650,P〈0. 001,95% CI 0. 515-0. 821）; Subgroup-analysis result reveals that,in smaller sample size population with CYP 2E1 C1C1 genotype have a gastric cancer risk of 2. 02 times the risk of having gastric cancer with CYP 2E1 C1C2 and C2C2 genotypes（ P〈0. 001,95% CI 1. 55-2. 64）,in bigger sample size population with CYP 2E1 C1C1 genotype have a gastric cancer risk of0. 93 times the risk of having gastric cancer with CYP 2E1 C1C2 and C2C2 genotypes（ P = 0. 586,95% CI 0. 71-1. 22）,in overall sample size population with CYP 2E1 C1C1 genotype have a gastric cancer risk of 1. 50 times the risk of having gastric cancer with CYP 2E1 C1C2 and C2C2 genotypes（ P = 0. 006,95% CI 1. 12-2. 00）. Conclusion The size of the sample is an important factor affecting the result. The small sample size of the study tends to get positive result. Whether CYP 2E1 C1C1 genotype of the population is a risk factor for gastric cancer remains to be further studied.