Tumor Necrosis Factor-Alpha Gene Promoter (TNF-α G-308A) Polymorphisms Increase the Risk of Hepatocellular Carcinoma in Asians: A Meta-Analysis.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common primary hepatic tumors, and it is ranked as the third most common cause of cancer-linked deaths. Although the precise etiology of HCC is unknown, inflammation has been considered the foremost cause of HCC. Previous studies indicated that tumor necrosis factor-alpha (TNF-α) is associated with increased risk of HCC, but the results are conflicting. In the present study, we assessed the correlation between TNF-α G-308A polymorphism as well as HCC risk via a meta-analysis. We searched databases such as PubMed, EMBASE, and Web of Science for articles related to this subject. To evaluate the correlation between TNF-α G-308A polymorphism and HCC, the odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Between-study heterogeneity was assessed using Cochrane Q test and I2 statistics. To assess the robustness of data, sensitivity analysis, publication bias, and subgroup analysis were conducted. Approximately 30 articles with 4,753 cases of HCC and 6,667 controls were included for the meta-analysis. Overall, the TNF-α G-308A polymorphism notably correlated with increased risk of HCC in the dominant model (OR = 1.41, 95% CI: 1.02-1.94, P = 0.036). Furthermore, a subgroup investigation showed significant correlation between TNF-α G-308A polymorphisms and HCC risk only in Asian populations (dominant model OR = 1.55, 95% CI: 1.05-2.23, P = 0.025). Studies in ethnic groups showed significant heterogeneity (I2 > 50%). Funnel plot and Eggers p values did not reveal publication bias. The present meta-analysis suggested that TNF-α G-308A polymorphisms are correlated with an elevated risk of HCC in Asian populations.