Chen Shimin, Chen Lu, Tan Yuling, Wang Jiehong
Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi.
Department of Gastroenterology, Affiliated Hospital of Shaanxi Chinese Medicine University, Xianyang, China.
Medicine (Baltimore). 2019 May;98(18):e15468. doi: 10.1097/MD.0000000000015468.
Previous studies have reported an association between cyclooxygenase-2 (COX-2) polymorphism and gastric cancer (GC) susceptibility, but their results are controversial. This meta-analysis was intended to evaluate the relationship between the COX-2 rs20417 polymorphism and GC susceptibility in different ethnic groups.
We searched PubMed, EMBASE, Web of Knowledge, and the Chinese Biomedical Database (CBM) for relevant case-control studies published up to October 6, 2018, which reported an association between the COX-2 rs20417 polymorphism and gastric cancer risk. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of this association.
15 papers detailing case-control studies were included in the analysis, which included a total of 2848 GC cases and 4962 healthy controls. The meta-analysis results indicated that the COX-2 rs20417 polymorphism was associated with increased GC susceptibility under allele (G vs C: OR = 1.67, 95%CI = 1.19-2.35, P = .003), heterozygous (GG vs CG: OR = 1.44, 95%CI = 1.03-2.02, P = .034), dominant (GC+CC vs GG: OR = 1.66, 95%CI = 1.18-2.34, P = .004), homozygous (GG vs CC:OR = 2.20, 95%CI = 1.07-4.54, P = .033), and recessive models (CC vs GG+CG:OR = 2.05, 95%CI = 1.09-3.85, P = .025). An analysis of ethnic subgroups revealed that the COX-2 rs20417 polymorphism was significantly associated with GC susceptibility in Asians under all 5 models (G vs C: OR = 2.22, 95%CI = 1.66-2.96, P < .001; GG vs CC: OR = 4.29, 95%CI = 1.94-9.50, P < .001; GG vs CG: OR = 1.86, 95%CI = 1.34-2.58, P < .001; CC vs GG+CG: OR = 3.73, 95%CI = 1.92-7.24, P < .001; GC+CC vs GG: OR = 2.20, 95%CI = 1.65-2.93, P < .001). Helicobacter pylori positive patients suffered a high risk of GC, compared to H pylori negative patients under the dominant model (OR = 3.09, 95%CI = 1.80-5.32, P < .001).
This meta-analysis of 15 case-control studies provides strong evidence that the COX-2 rs20417 polymorphism increases the risk of GC susceptibility in general populations, especially in Asians. Helicobacter pylori positive patients and those with the COX-2 rs20417 polymorphism had a higher risk of developing GC.
既往研究报道了环氧合酶-2（COX-2）基因多态性与胃癌（GC）易感性之间存在关联，但其结果存在争议。本荟萃分析旨在评估COX-2 rs20417基因多态性与不同种族人群GC易感性之间的关系。
我们检索了PubMed、EMBASE、Web of Knowledge和中国生物医学数据库（CBM），以查找截至2018年10月6日发表的相关病例对照研究，这些研究报道了COX-2 rs20417基因多态性与胃癌风险之间的关联。采用比值比（OR）及其95%置信区间（CI）来评估这种关联的强度。
15篇详细描述病例对照研究的论文纳入了分析，共包括2848例GC病例和4962例健康对照。荟萃分析结果表明，在等位基因（G vs C：OR = 1.67，95%CI = 1.19 - 2.35，P = 0.003）、杂合子（GG vs CG：OR = 1.44，95%CI = 1.03 - 2.02，P = 0.034）、显性（GC + CC vs GG：OR = 1.66，95%CI = 1.18 - 2.34，P = 0.004）、纯合子（GG vs CC：OR = 2.20，95%CI = 1.07 - 4.54，P = 0.033）和隐性模型（CC vs GG + CG：OR = 2.05，95%CI = 1.09 - 3.85，P = 0.025）下，COX-2 rs20417基因多态性与GC易感性增加相关。种族亚组分析显示，在所有5种模型下，COX-2 rs20417基因多态性与亚洲人群的GC易感性显著相关（G vs C：OR = 2.22，95%CI = 1.66 - 2.96，P < 0.001；GG vs CC：OR = 4.29，95%CI = 1.94 - 9.50，P < 0.001；GG vs CG：OR = 1.86，95%CI = 1.34 - 2.58，P < 0.001；CC vs GG + CG：OR = 3.73，95%CI = 1.92 - 7.24，P < 0.001；GC + CC vs GG：OR = 2.20，95%CI = 1.65 - 2.93，P < 0.001）。在显性模型下，与幽门螺杆菌阴性患者相比，幽门螺杆菌阳性患者患GC的风险更高（OR = 3.09，95%CI = 1.80 - 5.32，P < 0.001）。
这项对15项病例对照研究的荟萃分析提供了有力证据，表明COX-2 rs20417基因多态性增加了普通人群尤其是亚洲人群患GC的易感性。幽门螺杆菌阳性患者和携带COX-2 rs20417基因多态性的患者患GC的风险更高。
