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GSTM1和GSTT1空白基因型是肝细胞癌的危险因素之一:来自一项最新Meta分析的证据
Null genotypes of GSTM1 and GSTT1 contribute to hepatocellular carcinoma risk: Evidence from an updated meta-analysis
Wang B, Huang G, Wang D, Li A, Xu Z, Dong R, Zhang D, Zhou W  2010/9/17 12:10:00 
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Journal of Hepatology, 2010, Volume 53, Issue 3 
 

Background & Aims: Studies investigating the associations between glutathione S-transferase (GST) genetic polymorphisms and hepatocellular carcinoma (HCC) risk have reported controversial results. Thus, a meta-analysis was performed to clarify the effects of GSTM1 and GSTT1 polymorphisms on HCC risk. Methods: We identified 132 relevant records through a literature search up to November 22, 2009, and 24 individual case-control studies from 23 publications were finally included, involving a total of 3349 HCC cases and 5609 controls. Subgroup analyses were performed by ethnicity, or by area according to the incidence rate and hepatitis virus status. Results: Analyses of total relevant studies showed an increased HCC risk was significantly associated with null genotypes of GSTM1 (OR = 1.26, 95% CI 1.03-1.54, pOR = 0.027) and GSTT1 (OR = 1.28, 95% CI 1.09-1.51, pOR = 0.002). In addition, the GSTM1-GSTT1 interaction analysis showed that the dual null genotype of GSTM1/GSTT1 was significantly associated with increased HCC risk (OR = 1.89, 95% CI 1.38-2.60, pOR < 0.001). Subgroup analyses showed that the associations above were still statistically significant in Asians (p GSTM1 = 0.017, pGSTT1 = 0.001, p Dual null genotype < 0.001), high-rate areas (pGSTM1 = 0.012, pGSTT1 = 0.006, pDual null genotype < 0.001), and HBV-dominant areas (pGSTM1 = 0.003, pGSTT 1 = 0.003, pDual null genotype < 0.001). Conclusions: This meta-analysis suggests null genotypes of GSTM1 and GSTT1 are both associated with increased HCC risk in Asians, and individuals with the dual null genotype of GSTM1/GSTT1 are particularly susceptible to developing HCC. © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Correspondence Address: Zhou, W.; Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China; email:ehbhzhouwp@yahoo.cn 
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 王燕燕 王曙

上海交通大学附属瑞金医院内分泌科

患者,女,69岁。2009年1月无明显诱因下出现乏力,当时程度较轻,未予以重视。2009年3月患者乏力症状加重,尿色逐渐加深,大便习惯改变,颜色变淡。4月18日入我院感染科治疗,诉轻度头晕、心慌,体重减轻10kg。无肝区疼痛,无发热,无腹痛、腹泻、腹胀、里急后重,无恶性、呕吐等。入院半月前于外院就诊,查肝功能:ALT 601IU/L,AST 785IU/L,TBIL 97.7umol/L,白蛋白 41g/L,甲状腺功能:游离T3 30.6pmol/L,游离T4 51.9pmol/L,心电图示快速房颤。
 

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