Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu, China.
Arch Med Res. 2010 Oct;41(7):558-66. doi: 10.1016/j.arcmed.2010.09.003.
Studies investigating the association between glutathione S-transferase M1 (GSTM1) gene polymorphism and gastric cancer (GC) risk have reported conflicting results. In order to clarify the effect of GSTM1 genotype on the GC risk, we performed an updated meta-analysis of published case-control and cohort studies to better compare results between studies.
Published literature from PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) were retrieved, and the literature search was updated on June 15, 2010. 49 studies with 7746 cases of GC and 13,230 controls were selected. A fixed- or random-effects model was used to calculate pooled effect estimates depending on statistical heterogeneity.
The combined analyses showed that there was a significant difference in genotype distribution between GC cases and controls among Asians, but not among Caucasians. Stratified analyses according to control sources also showed the positive association between GSTM1 null genotype and increased risk of GC. However, smoking and Helicobacter pylori infection did not modify the association between this polymorphism and GC susceptibility (p = 0.56 and 0.31, respectively). When stratifying by the location, Lauren's classification, and histological differentiation of GC, we observed no statistically significant differences in genotype distribution. A strong correlation between increased GC risk and the combined GSTM1 and GSTT1 null genotype was observed.
This meta-analysis demonstrated that the GSTM1 gene polymorphism might be a risk factor for GC among Asians (especially, in some Eastern countries). Smoking, Helicobacter pylori infection status did not modify the association between GSTM1 null genotype and GC risk.
研究谷胱甘肽 S-转移酶 M1（GSTM1）基因多态性与胃癌（GC）风险之间的关联的研究结果相互矛盾。为了阐明 GSTM1 基因型对 GC 风险的影响，我们对已发表的病例对照和队列研究进行了更新的荟萃分析，以便更好地比较研究结果。
从 PubMed、EMBASE 和中国国家知识基础设施（CNKI）检索已发表的文献，文献检索更新至 2010 年 6 月 15 日。选择了 49 项包含 7746 例 GC 病例和 13230 例对照的病例对照和队列研究。根据统计学异质性，采用固定或随机效应模型计算合并效应估计值。
综合分析表明，亚洲人群 GC 病例与对照组之间的基因型分布存在显著差异，但白种人群中无此差异。根据对照来源进行的分层分析也显示 GSTM1 缺失基因型与 GC 风险增加之间存在正相关。然而，吸烟和幽门螺杆菌感染并不能改变这种多态性与 GC 易感性之间的关联（分别为 p = 0.56 和 0.31）。当按 GC 的位置、Lauren 分类和组织学分化进行分层时，我们观察到基因型分布没有统计学上的显著差异。我们还观察到，GC 风险增加与 GSTM1 和 GSTT1 缺失基因型的联合存在很强的相关性。
本荟萃分析表明，GSTM1 基因多态性可能是亚洲人群（特别是某些东方国家）发生 GC 的一个危险因素。吸烟、幽门螺杆菌感染状态并不能改变 GSTM1 缺失基因型与 GC 风险之间的关联。
