Abstract
BackgroundTumor necrosis factor- alpha (TNF-α) is an inflammatory cytokine which may play important role on the immune response may control the progression of cervical lesions. There is a possible association between TNF-α rs1800629 G/A polymorphism and cervical lesions, but previous studies report conflicting results. We performed a meta-analysis to comprehensively assess the association between TNF-α rs1800629 polymorphism and cervical lesions risk.MethodsLiterature searches of Pubmed, Embase, Web of Science, and Wanfang databases were performed for all publications on the association between TNF-α rs1800629 polymorphism and cervical lesions through December 15, 2012. The pooled odds ratios (ORs) with their 95% confidence interval (95%CIs) were calculated to assess the strength of the association.ResultsTwenty individual case-control studies from 19 publications with a total of 4,146 cases and 4,731 controls were finally included into the meta-analysis. Overall, TNF-α rs1800629 polymorphism was significantly associated with increased risk of cervical lesions under two main genetic comparison models (For A versus G: OR 1.22, 95%CI 1.04–1.44, P = 0.017; for AA versus GG: OR 1.32, 95%CI 1.02–1.71, P = 0.034). Subgroup analysis by ethnicity further showed that there was a significant association between TNF-α rs1800629 polymorphism and increased risk of cervical lesions in Caucasians but not in Asians. Subgroup analysis by the types of cervical lesions showed that there was a significant association between TNF-α rs1800629 polymorphism and increased risk of cervical cancer (For A versus G: OR 1.24, 95%CI 1.05–1.47, P = 0.011; for AA versus GG: OR 1.31, 95%CI 1.01–1.70, P = 0.043; for AA/GA versus GG: OR 1.25, 95%CI 1.01–1.54, P = 0.039).ConclusionThe meta-analysis suggests that TNF-α rs1800629 polymorphism is associated with increased risk of cervical lesions, especially in Caucasians.
Highlights
Cervical cancer is the third most common cancer and the fourth leading cause of cancer death among females, accounting for nearly 10% of the total newly-diagnosed cancer cases and 8% of the total cancer deaths [1]
Since the research by Kohaar et al assessed the associations of Tumor necrosis factor- alpha (TNF-a) rs1800629 polymorphism with risks of both cervical cancer and squamous intraepithelial lesions, the data were extracted as two individual studies [21]
Meta-analysis Meta-analysis of all 20 studies showed that there was a significant association between TNF-a rs1800629 polymorphism and cervical lesions risk under two main genetic comparison models (For A versus G: odds ratios (ORs) 1.22, 95%CI 1.04–1.44, P = 0.017; for AA versus GG: OR 1.32, 95%CI 1.02–1.71, P = 0.034) (Table 2, Figure 2)
Summary
Cervical cancer is the third most common cancer and the fourth leading cause of cancer death among females, accounting for nearly 10% of the total newly-diagnosed cancer cases and 8% of the total cancer deaths [1]. It has been well accepted that cervical cancer is mainly initiated by HPV infection, and tumor necrosis factor-alpha (TNF-a) is an inflammatory cytokine which may play important roles in the immune response of cervical lesions [5,7]. Results from previous studies examining the association between TNF-a rs1800629 polymorphism and risk of cervical lesions were contradictory [12–25]. These inconclusive results may due to the limited sample size of single study or the different characteristics among studies, such as ethnicity, pathological types, and sources of controls. Tumor necrosis factor- alpha (TNF-a) is an inflammatory cytokine which may play important role on the immune response may control the progression of cervical lesions. We performed a meta-analysis to comprehensively assess the association between TNF-a rs1800629 polymorphism and cervical lesions risk
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