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目的采用meta分析的方法定量评价环氧化酶-2(COX-2)基因–765G>C位点多态性与结直肠癌易感性的关系。方法计算机检索Pub Med、Embase、The Cochrane Library、CNKI、CBM、VIP和万方数据库,搜集有关COX-2基因–765G>C位点多态性与结直肠癌发病风险相关性的病例对照研究,检索时限均从建库至2016年5月。由两位评价员独立筛选文献并提取资料,采用Stata 12.0软件进行meta分析。结果共纳入13个病例对照研究,包括4 998例结直肠癌患者和7 750位健康对照者。总体人群的meta分析结果显示:COX-2基因–765G>C位点多态性与结直肠癌易感性无关[GG vs.GC:OR=0.98,95%CI(0.89,1.07),P=0.590;GC vs.CC:OR=0.85,95%CI(0.65,1.11),P=0.236;GG vs.CC:OR=0.86,95%CI(0.66,1.12),P=0.275;GG+GC vs.CC:OR=0.87,95%CI(0.67,1.13),P=0.288);GG vs.GC+CC:OR=0.97,95%CI(0.89,1.05),P=0.425]。亚组分析结果显示,COX-2基因–765G>C位点多态性的GG vs.GC和GG vs.GC+CC模型与亚洲人种结直肠癌的易感性可能有关[GG vs.GC:OR=0.70,95%CI(0.58,0.86),P=0.001;GG vs.GC+CC:OR=0.71,95%CI(0.58,0.87),P=0.001],而其他模型与结直肠癌的易感性无关[GC vs.CC:OR=1.74,95%CI(0.61,5.00),P=0.301;GG vs.CC:OR=1.18,95%CI(0.40,3.45),P=0.762;GG+GC vs.CC:OR=1.50,95%CI(0.53,4.23),P=0.440];COX-2基因–765G>C位点多态性与高加索人种结直肠癌的易感性无关[GG vs.GC:OR=1.05,95%CI(0.95,1.16),P=0.321;GC vs.CC:OR=0.80,95%CI(0.61,1.01),P=0.129;GG vs.CC:OR=0.85,95%CI(0.64,1.11),P=0.228;GG+GC vs.CC:OR=0.83,95%CI(0.64,1.09),P=0.198;GG vs.GC+CC:OR=1.03,95%CI(0.94,1.13),P=0.526]。结论当前证据显示,COX-2基因–765G>C位点多态性可能与亚洲人种结直肠癌易感性有关,而与高加索人种结直肠癌易感性无关。
Objective To quantitatively evaluate the relationship between the polymorphism of -765G> C of cyclooxygenase-2 (COX-2) gene and susceptibility to colorectal cancer by meta-analysis. Methods PubMed, Embase, The Cochrane Library, CNKI, CBM, VIP and Wanfang database were searched to collect case-control studies on the association between -765G> C polymorphism of COX-2 gene and the risk of colorectal cancer. Search time from the construction of the library to May 2016. The two reviewers independently screened the literature and extracted the data, using Stata 12.0 software for meta-analysis. Results A total of 13 case-control studies were included, including 4 998 cases of colorectal cancer and 7 750 healthy controls. The meta-analysis of the overall population showed no association between the -765G> C polymorphism in the COX-2 gene and susceptibility to colorectal cancer (GG vs. GC: OR = 0.98, 95% CI, 0.89, 1.07) ; GC vs. CC: OR = 0.85, 95% CI (0.65, 1 .1 1), P = 0.236; GG vs. CC: OR = 0.86, 95% CI (0.66, 1.12), P=0.275; GG + GC vs. CC: OR = 0.87, 95% CI (0.67, 1.13), P = 0.288); GG vs. GC + CC: OR = 0.97, 95% CI (0.89, 1.05), P = 0.425]. Subgroup analysis showed that the GG vs. GG and GG vs. GC + CC models of COX-2 -765G> C polymorphism may be related to susceptibility to colorectal cancer in Asian populations [GG vs. GC: OR = 0.70,95% CI (0.58,0.86), P = 0.001; GG vs. GC + CC: OR = 0.71, 95% CI (0.58,0.87), P = 0.001] while other models were associated with colorectal cancer [GC vs. CC: OR = 1.74, 95% CI (0.61, 5.00), P = 0.301; GG vs. CC: OR = 1.18, 95% CI GC vs.CC:OR=1.50,95%CI(0.53,4.23),P=0.440]COX-2-765G> C polymorphism was not associated with susceptibility to Caucasian colorectal cancer [GG vs . GC: OR = 1.05, 95% CI (0.95,1.16), P = 0.321; GC vs. CC: OR = 0.80, 95% CI 0.61, 1.01, P = 0.129; GG vs. CC: , 95% CI (0.64,1.11), P = 0.228; GG + GC vs. CC: OR = 0.83,95% CI (0.64,1.09), P = 0.198GG vs. GC + CC: OR = 1.03,95 % CI (0.94, 1.13), P = 0.526]. Conclusions Current evidence indicates that polymorphisms at the -765G> C locus of COX-2 gene may be associated with susceptibility to colorectal cancer in Asian populations, but not with susceptibility to Caucasian colorectal cancer.