亚甲基四氢叶酸还原酶C677T基因多态性与胃癌易感性的Meta分析

A Meta-analysis on Relationship of MTHFR C677T Polymorphism and Susceptibility to Gastric Cancer

目的运用Meta分析法探讨亚甲基四氢叶酸还原酶(methylenetetrahdrofolate reductase,MTHFR)C677T基因多态性与胃癌易感性的关系。方法通过计算机检索PubMed、EMBASE、中国生物医学文献数据库(CBM)、中文科技期刊数据库(CSTJ)、中国期刊全文数据库(CJFD),追查纳入文献的参考文献,收集有关MTHFR C677T基因多态性与胃癌易感性关系的病例对照研究。利用Stata SE12软件对纳入研究进行统计分析和异质性检验。结果共纳入文献30篇,总计胃癌病例8 161例,对照9 926例。结果显示,MTHFR C677T变异基因型(CT+TT)胃癌的发病风险是野生型患者的1.31倍(95%CI:1.14~1.50),按亚洲、北美洲、欧洲人群分层分析显示亚洲人群MTHFR C677T变异基因型(CT+TT)与胃癌的发生相关(OR=1.35,95%CI:1.16~1.58),而在北美洲(OR=0.93,95%CI:0.41~2.11)和欧洲(OR=1.25,95%CI:0.81~1.93)人群则未发现有关联。敏感度分析显示该结果总合并值较为稳定,亚洲人群的合并值也较稳定,但北美洲及欧洲人群的合并值不稳定。漏斗图及Egger检验显示存在发表偏倚。结论 MTHFR C677T变异基因型(CT+TT)可能是亚洲人群胃癌的危险因素。

Objecive To clarify the effect of methylenetetrahdrofolate reductase(MTHFR) C677T polymorphism on the susceptibility to gastric cancer by Meta-analysis. Methods We performed a computerized search of PubMed, EMBASE, Chinese Biomedical Literature Database(CBM), China Science and Technology Journal Database(CSTJ), Chinese Journal Full-text Database(CJFD) to identity case-control studies on the relationship between MTHFR C677T polymorphism and the susceptibility to gastric cancer. We also retrieved the references of the included studies. Statistic analysis and heterogeneity test were conducted by Stata SE12. Results Thirty studies were included, with 8 161 cases of gastric cancer and 9 926 controls. MTHFR C677T mutation genotype CT+TT was associated with 1.31 times of risk of gastric cancer compared with CC(C677C) genotype(95%CI: 1.14-1.50). Subgroup analysis showed an increased risk in the Asians(OR=1.35,95%CI: 1.16-1.58), but no association in the North Americans(OR=0.93, 95%CI: 0.41-2.11) or the Europeans(OR=1.25, 95%CI: 0.81-1.93). Sensitivity analysis showed stable synthesized values, but unstable in the North Americans or the Europeans. The funnel plot and Egger's test provided the evidence of publication bias. Conclusion MTHFR C677T mutation genotype may contribute to the susceptibility to gastric cancer in the Asians.