MTHFR基因C677T和A1298C多态与贲门癌的遗传易感性

目的 探讨代谢叶酸的亚甲基四氢叶酸还原酶（MTHFR）基因单核苷酸多态与贲门癌风险的关系。方法 以聚合酶链反应和限制性片段长度多态方法,分析了205个贲门癌病人和性别、年龄配对的360个正常对照 MTHFR基因C677T和A1298C基因型及其对贲门癌风险的相关性。结果 在正常对照中,MTHFR 677CC、CT、TT基因型频率分别为35.0%、47．8％和17．2％,而在贲门癌病人中分别为20．5％、50．7％和28．85（χ^2=17.63,P=0.0002)。多因素分析发现,携带677CT或677TT基因型的个体发生贲门癌的风险比677CC基因型分别高1.76倍（95％可信区限1.13-2.76)和2.97倍（95%可信区限1.75-5.05)。MTHFR A1298C基因型在病例和对照中的分布差异无显著性意义（χ^2=0.08,P=0.96),但1298变异基因型与677变异基因型之间有协同作用。携带MTHFR 677CT/1298CC基因型个体发生贲门癌的风险是携带MTHFR 677CC/1298AA基因型个体的17倍（95％可信区限1．26－无穷大）。结论 MTHFR单核苷酸多态是中国人贲门癌的遗传易感性因素。

Single nucleotide polymorphisms in methylenetetrahydrofolate reductase gene and susceptibility to cancer of the gastric cardia in Chinese population

OBJECTIVE: To explore the relationship between genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR), a central enzyme in folate metabolism that affects DNA methylation and synthesis, and the risk of adenocarcinoma of the gastric cardia (AGC). METHODS: Genomic DNA was isolated from the peripheral lymphocytes of 205 patients with AGC and 360 age-and-sex-matched control subjects. Polymerase chain reaction and restriction fragment length polymorphism were used to examine the polymorphisms of MTHFR genes C6677T and A1298C and the relation between these genotypes and risk of AGC was analyzed. RESULTS: The genotype frequency of MTHFR C677CC was 35.0% among the controls and was 20.5% among the AGC patients; the genotype frequency of 677CT was 47.8% among the controls and 50.7% among the AGC patients, and the genotype frequency of 677TT was 17.2% among the controls and 28.8% among the AGC patients % (chi(2) = 17.63, P = 0.0002). The individuals with 677CT genotype or 677TT genotype had a 1.76-fold 95% confidence interval (CI), 1.13 - 2.76] or 2.97-fold (95% CI, 1.75 - 5.05) increased risk of developing AGC compared with those who had 677CC genotype. The distribution of MTHFR A1298C genotype was not significantly different between the two groups (chi(2) = 0.08, P = 0.96). The value of odd ratio (OR) in the individuals with 677CT//1298AA genotype (95% CI, 1.48 approximately 6.48), and the value of OR in the individuals with 677CT/1298CC genotype was 17.00 (95% CI, 1.26 approximately infinity; P = 0.042). CONCLUSION: Single nucleotide polymorphism in the MTHFR gene is a risk factor of carcinogenesis of AGC in the Chinese population. Although the MTHFR A1298C polymorphism was not associated with AGC, The risk of developing AGC in the individuals with MTHFR677CT/1298CC was 17 times higher than that in the individuals with MTHFR677CC/1298AA, thus showing that a joint effect exists between the MTHFR 677 and 1298 polymorphisms on the risk of AGC.