Mocellin Simone, Nitti Donato
Meta-analysis Unit, Department of Oncological and Surgical Sciences, University of Padova, Padova, Italy.
Cancer. 2008 Nov 1;113(9):2398-407. doi: 10.1002/cncr.23867.
It has been hypothesized that polymorphisms in the vitamin D receptor (VDR) gene affect the risk of developing melanoma. However, results often are conflicting, and no meta-analysis has been performed to date on published data. Six studies (cases, 2152; controls, 2410) that investigated the association between 5 VDR polymorphisms (TaqI, FokI, BsmI, EcoRV, and Cdx2) and the risk of melanoma were retrieved and analyzed. The model-free approach was applied to meta-analyze these molecular association studies. Available data suggested a significant association between the BsmI VDR polymorphism and melanoma risk (pooled odds ratio [OR], 1.30; 95% confidence interval [CI], 1.11-1.53; P= .002; heterogeneity Cochran Q test, P> .1), and the population-attributable risk was 9.2%. In contrast, the FokI polymorphism did not appear to be associated with such risk (OR, 1.09; 95% CI, 0.99-1.21; P= .07; heterogeneity Cochran Q test, P> .1). For the TaqI and the EcoRV polymorphisms, significant between-study heterogeneity did not support genotype data pooling. Only 1 study investigated the Cdx2 variant, and the findings were negative. Current evidence is in favor of an association between 1 VDR gene polymorphism (BsmI) and the risk of developing melanoma. The current findings prompt further investigation on this subject and indirectly support the hypothesis that sun exposure may have an antimelanoma effect through activation of the vitamin D system.
有假说认为,维生素D受体(VDR)基因多态性会影响患黑色素瘤的风险。然而,研究结果往往相互矛盾,且迄今为止尚未对已发表的数据进行荟萃分析。检索并分析了六项研究(病例2152例;对照2410例),这些研究调查了5种VDR多态性(TaqI、FokI、BsmI、EcoRV和Cdx2)与黑色素瘤风险之间的关联。采用无模型方法对这些分子关联研究进行荟萃分析。现有数据表明,BsmI VDR多态性与黑色素瘤风险之间存在显著关联(合并比值比[OR]为1.30;95%置信区间[CI]为1.11 - 1.53;P = .002;异质性Cochran Q检验,P > .1),人群归因风险为9.2%。相比之下,FokI多态性似乎与该风险无关(OR为1.09;95% CI为0.99 - 1.21;P = .07;异质性Cochran Q检验,P > .1)。对于TaqI和EcoRV多态性,研究间显著的异质性不支持合并基因型数据。仅一项研究调查了Cdx2变异,结果为阴性。目前的证据支持一种VDR基因多态性(BsmI)与患黑色素瘤风险之间的关联。当前的研究结果促使对该主题进行进一步研究,并间接支持了以下假说:阳光照射可能通过激活维生素D系统产生抗黑色素瘤作用。