亚甲基四氢叶酸还原酶基因多态性与中国儿童急性淋巴细胞白血病关系的Meta分析

目的 探讨亚甲基四氢叶酸还原酶（MTHFR）基因多态性与中国儿童急性淋巴细胞白血病（ALL）易感性的关系.方法 全面检索、收集评估MTHFR基因多态性与儿童ALL关系的病例-对照研究,纳入符合入选标准的文献,应用RevMan 5.1软件对纳入研究进行异质性检验和效应值合并,评估发表性偏倚和进行敏感度分析.结果 共纳入6篇文献,包括儿童ALL患者1215例,对照1572例.异质性检验结果表明纳入研究间无显著异质性,采用固定效应模型进行数据合并.Meta分析结果显示,MTHFR基因677位点TT、CT、TT＋ CT的合并OR及95％ CI分别为0.88（0.72 ～ 1.08）,0.85（0.73 ～0.99）,0.77（0.66～0.91）,对应Z值分别为1.22,2.06,3.15;MTHFR基因1298位点CC、AC、CC＋ AC的合并OR及95％ CI分别为1.13（0.75 ～1.70）、0.99（0.83 ～1.18）、1.01（0.85 ～1.19）,对应Z值分别为0.57、0.14、0.09.漏斗图未检测出显著性发表性偏倚.结论 MTHFR基因677CT基因型对中国儿童ALL的发生起保护作用,而677TT基因型与儿童ALL的发生无关联;MTHFR基因A1298C多态性与中国儿童ALL易感性无显著相关性.

Meta-analysis of MTHFR Genetic Polymorphisms and Pediatric Acute Lymphocytic Leukemia in Chinese

Objective To evaluate the relationship between methylenetetrahydrofolate reductase（MTHFR） genetic polymorphisms and susceptibility to pediatric acute lymphocytic leukemia（ALL） in Chinese.Methods Relevant literatures were extensively searched for collecting the case-control studies assessing the correlation of MTHFR genetic polymorphisms and pediatric ALL.The RevMan 5.1 was applied for heterogeneity test and combined ORs and their 95％ CIs calculation.Publication bias was assessed through funnel plot.Results 6 related literatures were included in the meta-analysis,totally including 1215 cases and 1572 controls.Based on the heterogeneity results,fixed-effects models were applied to estimate the pooled ORs.The pooled ORs（95％ CIs） for MTHFR 677TT,677CT and 677（TT ＋ CT） genotypes were 0.88 （0.72-1.08）,0.85 （0.73-0.99）,0.77 （0.66-0.91）,respectively with Z =1.22,2.06,3.15.The pooled ORs（95％ CIs） for MTHFR 1298CC,1298AC and 1298 （CC ＋ AC） genotypes were 1.13 （0.75-1.70）,0.99 （0.83-1.18）,1.01 （0.85-1.19）,respectively with Z =0.57,0.14,0.09,all P ＞ 0.05.No significant publication bias was detected by funnel plot and sensitivity analysis suggests robustness of the results.Conclusion MTHFR 677CT genotype was a protective factor of pediatric ALL development,while no correlation between 677TT genotype and pediatric ALL risk was found.MTHFR A1298C polymorphism was not associated with the risk of ALL in Chinese children.