结直肠癌患者MTHFR C677T基因多态性与基于氟尿嘧啶化疗方案疗效关系的系统评价

The correlation between the polymorphism of MTHFR C677T gene and the efficacy of fluorouracil-based chemotherapy in colorectal cancer patients: a systematic review

目的系统性评价结直肠癌患者MTHFR C677T基因多态性与以氟尿嘧啶类药物为基础的化疗方案疗效之间的相关性。方法检索中国期刊网全文数据库(CNKI)、维普数据库、Pub Med、Embase和Web of Science数据库,时限为各数据库建库时间至2018年1月。2名研究者按照纳入与排除标准独立筛选文献、提取资料。采用Stata12. 0软件进行Meta分析,计算等位基因(T vs C)遗传模型下的效应量,以优势比(OR)及95%置信区间(CI)描述效应量,I2和Q检验评价异质性,采用逐一排除法进行敏感性分析,Begg检验和Egger检验评估发表偏倚。结果共纳入16项研究,共计1 521例患者。Meta分析结果显示,在等位基因模型中,MTHFR C677T基因多态性与氟尿嘧啶类药物化疗敏感性间无显著相关性(T vs C:OR=1. 05,95%CI=0. 80-1. 38)。按人种差异进行亚组分析也得到了同样的结果。敏感性分析显示研究结果较稳定,Begg和Egger检验结果表明纳入研究无明显发表偏倚。结论 MTHFR C677T基因多态性不是预测结直肠癌患者对含氟尿嘧啶类药物化疗方案敏感性的可靠指标。

Objective To systematically evaluate the correlation between MTHFR C677T polymorphism and the efficacy of fluorouracil chemotherapy in colorectal cancer patients. Methods Two researchers, by retrieving databases such as CNKI, VIP, PubMed, Embase and Web of Science （starting from the time of establishment of the database to January of 2018）, screened relevant literature and information in accordance with the criteria for inclusion and exclusion. The obtained data were analyzed with Stata software （version 12） for Meta analysis and calculated the amount of effects under the genetic model of the allele （T vs C） and described with OR s and 95% CI. The heterogeneity is evaluated by 12 test and Q test. Sensitivity analysis using sequential exclusion method, and the publication bias was assessed by Begg＇s test and Egger＇s test. Results A total of 1521 patients were included in 16 studies. Meta analysis showed that there was no significant correlation between the polymorphism of MTHFR C677T gene and the sensitivity of fluorouracil chemotherapy in the allele model （ T vs C ： OR = 1.05, 95% CI = 0.80 - 1.38）. Subgroup analysis based on race differences gave the same results. Sensitivity analysis showed that the results of the study were relatively stable. Begg＇s test and Egger test showed that there was no significant publication bias in the study. Conclusion The polymorphism of MTHFR C677T gene can not be used as a reliable predictor of sensitivity of colorectal cancer patients to fluorouracil chemotherapy.