Zhang Haiyan, Zhang Zhen, Li Guang, Wang Surong, Zhang Shiqian, Xie Beibei
From the Department of Gynecology, Affiliated Qilu Hospital of Shandong University, Jinan, China (HZ) and Gynecology Ward-1 (HZ, ZZ, BX); Department of Gastrointestinal Surgery (GL), and Gynecology Ward-3 (SW), Linyi City People's Hospital, Shandong Province, China.
Medicine (Baltimore). 2015 Sep;94(35):e1168. doi: 10.1097/MD.0000000000001168.
The Fc receptor-like 3 (FCRL3) gene was reported to be linked to a variety of autoimmune diseases, including endometriosis-related infertility. However, this linkage has not been studied in Chinese population and there has been no meta-analysis on the interrelationship of FCRL3 gene and endometriosis-related infertility. The aim of the study was to investigate the association between FCRL3 genetic polymorphisms and the risk of endometriosis-related infertility in Han Chinese, and a further meta-analysis was conducted to confirm our results.Four single nucleotide polymorphisms (SNPs) (rs7528684 [FCRL3_3], rs11264799 [FCRL3_4], rs945635 [FCRL3_5], and rs3761959 [FCRL3_6]) on FCRL3 gene were genotyped in a case-control cohort composed of 217 patients suffering from endometriosis-related infertility and 220 healthy controls using cleaved amplification polymorphism sequence-tagged sites (polymerase chain reaction-restriction fragment length polymorphism, PCR-RFLP). Odds ratio (OR) and its 95% confidence interval (CI) was used to evaluate the association quantitatively. Furthermore, a meta-analysis of previous studies including the present study was implemented through Stata 11.0 (Stata Corporation, College Station, TX).We found an approximately 1.4-fold significantly increased frequency of the FCRL3_3 variant in women with endometriosis-related infertility over the controls (OR = 1.41 [95% CI = 1.08-1.84], P = 0.013). However, no significant difference was found between women with endometriosis-related infertility and controls for FCRL3_4, FCRL3_5, and FCRL3_6. Regardless of the symptoms and the revised classification of the American Society of Reproductive Medicine (rASRM) stage of endometriosis, there was a significant association between FCRL3_3 variant and an increased risk of endometriosis-related infertility. Meta-analysis of previous studies combined with the present study further confirmed the association between FCRL3_3 and the risk of endometriosis-related infertility.In summary, the present study suggested that FCRL3_3 variant was associated with an increased risk of endometriosis-related infertility, regardless of symptoms, and rASRM stage of the patients. Meta-analysis of previous studies combined with the present study further confirmed our results. Further large-scale studies in the future are warranted to explore the association between FCRL3 genetic polymorphisms and endometriosis-related infertility, as well as other human diseases, in Asian and other ethnicities.
据报道,Fc受体样3(FCRL3)基因与多种自身免疫性疾病有关,包括子宫内膜异位症相关的不孕症。然而,尚未在中国人群中研究这种关联,也没有关于FCRL3基因与子宫内膜异位症相关不孕症之间相互关系的荟萃分析。本研究的目的是调查FCRL3基因多态性与中国汉族人群中子宫内膜异位症相关不孕症风险之间的关联,并进行进一步的荟萃分析以证实我们的结果。
使用切割扩增多态性序列标签位点(聚合酶链反应-限制性片段长度多态性,PCR-RFLP)对FCRL3基因上的四个单核苷酸多态性(SNP)(rs7528684 [FCRL3_3]、rs11264799 [FCRL3_4]、rs945635 [FCRL3_5]和rs3761959 [FCRL3_6])在一个病例对照队列中进行基因分型,该队列由217例患有子宫内膜异位症相关不孕症的患者和220例健康对照组成。采用优势比(OR)及其95%置信区间(CI)进行定量评估关联。此外,通过Stata 11.0(Stata公司,德克萨斯州大学城)对包括本研究在内的先前研究进行荟萃分析。
我们发现,与对照组相比,患有子宫内膜异位症相关不孕症的女性中FCRL3_3变异的频率显著增加了约1.4倍(OR = 1.41 [95% CI = 1.08 - 1.84],P = 0.013)。然而,在患有子宫内膜异位症相关不孕症的女性和对照组之间,FCRL3_4、FCRL3_5和FCRL3_6没有发现显著差异。无论子宫内膜异位症的症状和美国生殖医学学会(rASRM)修订分期如何,FCRL3_3变异与子宫内膜异位症相关不孕症风险增加之间均存在显著关联。对先前研究与本研究的荟萃分析进一步证实了FCRL3_3与子宫内膜异位症相关不孕症风险之间的关联。
总之,本研究表明,无论患者的症状和rASRM分期如何,FCRL3_3变异均与子宫内膜异位症相关不孕症风险增加有关。对先前研究与本研究的荟萃分析进一步证实了我们的结果。未来有必要进行进一步的大规模研究,以探索FCRL3基因多态性与亚洲及其他种族中子宫内膜异位症相关不孕症以及其他人类疾病之间的关联。