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目的系统评价环氧合酶-2(COX-2)-765G>C(rs20417)基因多态性与胃癌发病风险的关系。方法计算机检索Pub Med、EMbase、The Cochrane Library(2015年10期)、中国生物医学文献数据库、中国知网学术总库、万方数据库和维普中文科技期刊数据库,搜集有关COX-2-765 G>C基因多态性与胃癌罹患风险相关性的病例-对照研究,检索时限为建库至2015年10月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析。结果共纳入15个病例-对照研究,包括2 891例胃癌患者和4 967例对照。Meta分析结果显示,COX-2-765 G>C(rs20417)基因多态性与胃癌罹患风险有关[OR=1.70,95%CI(1.21,2.38),P=0.002]。亚组分析结果显示:在亚洲人群中,COX-2-765 G>C(rs20417)基因多态性与胃癌患病风险相关[OR=2.24,95%CI(1.70,2.96),P=0.000],但在高加索人群和美洲人群中其相关性无统计学意义。在显性遗传模型下,COX-2-765 G>C(rs20417)基因多态性与胃癌罹患风险的相关性在幽门螺杆菌感染阳性与阴性患者间差异有统计学意义[OR=2.11,95%CI(1.41,3.14),P<0.001]。结论 COX-2-765 G>C(rs20417)基因多态性可能会增加胃癌发病风险,尤其以亚洲人群的风险增加为明显。
Objective To evaluate the relationship between COX-2 -765G> C (rs20417) gene polymorphism and the risk of gastric cancer. METHODS: We searched PubMed, EMbase, The Cochrane Library (2015, 10), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database and VIP Chinese Science and Technology Database to collect information about COX-2-765 G> C gene polymorphism and gastric cancer risk-related case-control study, search time limit for the construction of libraries to October 2015. After two independent reviewers screened the literature, extracted data and evaluated the risk of inclusion in the study, a Meta-analysis was performed using Stata 12.0 software. Results A total of 15 case-control studies were included, including 2,891 gastric cancer patients and 4,967 controls. Meta-analysis showed that the COX-2-765G> C (rs20417) gene polymorphism was associated with the risk of gastric cancer [OR = 1.70,95% CI (1.21,2.38), P = 0.002]. Subgroup analysis showed that in Asia, COX-2-765 G> C (rs20417) gene polymorphism was associated with the risk of gastric cancer [OR = 2.24, 95% CI 1.70, 2.96, P = 0.000] , But the correlation was not statistically significant in Caucasians and the Americas. The relationship between the COX-2-765 G> C (rs20417) gene polymorphism and the risk of gastric cancer was statistically significant in patients with positive and negative H. pylori infection under the dominant genetic model [OR = 2.11, 95 % CI (1.41, 3.14), P <0.001]. Conclusions COX-2-765G> C (rs20417) gene polymorphism may increase the risk of gastric cancer, especially in Asian population.