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亚甲基四氢叶酸还原酶(MTHFR)多态性与宫颈病变易感性的关系:荟萃分析。

Methylenetetrahydrofolate reductase (MTHFR) polymorphisms and susceptibility for cervical lesions: a meta-analysis.

机构信息

Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

PLoS One. 2012;7(12):e52381. doi: 10.1371/journal.pone.0052381. Epub 2012 Dec 21.

Abstract

BACKGROUND

The association between the methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphisms and the susceptibility to cervical lesions was unclear. This study was designed to investigate their precise association using a large-scale meta-analysis.

METHODS

The previous 16 studies were identified by searching PubMed, Embase and CBM databases. The crude odds ratios and their corresponding 95% confidence intervals (CIs) were used to estimate the association between the MTHFR C677T/A1298C polymorphisms and the susceptibility to the cervical lesions. The subgroup analyses were made on the following: pathological history, geographic region, ethnicity, source of controls and source of DNA for genotyping.

RESULTS

Neither of the polymorphisms had a significant association with the susceptibility to the cervical lesions in all genetic models. Similar results were found in the subgroup analyses. No association was found between the MTHFR C677T polymorphism and the cervical lesions in the Asia or the America populations though a significant inverse association was found in the Europe population (additive model: P = 0.006, OR = 0.83, 95% CI = 0.72-0.95; CT vs. CC: P = 0.05, OR = 0.83, 95% CI = 0.69-1.00; TT vs. CC: P = 0.05, OR = 0.73, 95% CI = 0.53-1.00). Interestingly, women with the MTHFR A1298C polymorphisms had a marginally increased susceptibility to invasive cancer (ICC) when compared with no carriers but no statistically significant difference in the dominant model (P = 0.06, OR = 1.21, 95% CI = 0.99-1.49) and AC vs. AA (P = 0.09, OR = 1.21, 95% CI = 0.97-1.51).

CONCLUSIONS

The MTHFR C677T and A1298C polymorphisms may not increase the susceptibility to cervical lesions. However, the meta-analysis reveals a negative association between the MTHFR C677T polymorphisms and the cervical lesions, especially in the European populations. The marginal association between the MTHFR A1298C polymorphisms and the susceptibility to cervical cancer requires a further study.

摘要

背景

亚甲基四氢叶酸还原酶(MTHFR)C677T/A1298C 多态性与宫颈病变易感性之间的关系尚不清楚。本研究旨在通过大规模荟萃分析来探讨它们之间的确切关联。

方法

通过检索 PubMed、Embase 和 CBM 数据库,确定了之前的 16 项研究。使用粗比值比及其相应的 95%置信区间(CI)来估计 MTHFR C677T/A1298C 多态性与宫颈病变易感性之间的关联。对以下方面进行了亚组分析:病理史、地理位置、种族、对照来源和用于基因分型的 DNA 来源。

结果

在所有遗传模型中,两种多态性均与宫颈病变的易感性无关。亚组分析也得出了类似的结果。在亚洲或美洲人群中,MTHFR C677T 多态性与宫颈病变无关,但在欧洲人群中发现了显著的反向关联(加性模型:P=0.006,OR=0.83,95%CI=0.72-0.95;CT 与 CC:P=0.05,OR=0.83,95%CI=0.69-1.00;TT 与 CC:P=0.05,OR=0.73,95%CI=0.53-1.00)。有趣的是,与非携带者相比,MTHFR A1298C 多态性携带者患浸润性癌(ICC)的易感性略有增加,但在显性模型中没有统计学差异(P=0.06,OR=1.21,95%CI=0.99-1.49)和 AC 与 AA(P=0.09,OR=1.21,95%CI=0.97-1.51)。

结论

MTHFR C677T 和 A1298C 多态性可能不会增加宫颈病变的易感性。然而,荟萃分析显示 MTHFR C677T 多态性与宫颈病变之间存在负相关,尤其是在欧洲人群中。MTHFR A1298C 多态性与宫颈癌易感性之间的边缘关联需要进一步研究。

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