Objective:
Previous studies have reported an association between cyclooxygenase-2 (
COX
-
2
) polymorphism and gastric cancer (GC) susceptibility, but their results are controversial. This meta-analysis was intended to evaluate the relationship between the
COX
-
2
rs20417 polymorphism and GC susceptibility in different ethnic groups.
Methods:
We searched PubMed, EMBASE, Web of Knowledge, and the Chinese Biomedical Database (CBM) for relevant case-control studies published up to October 6, 2018, which reported an association between the
COX
-
2
rs20417 polymorphism and gastric cancer risk. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of this association.
Results:
15 papers detailing case-control studies were included in the analysis, which included a total of 2848 GC cases and 4962 healthy controls. The meta-analysis results indicated that the
COX
-
2
rs20417 polymorphism was associated with increased GC susceptibility under allele (G vs C: OR = 1.67, 95%CI = 1.19–2.35,
P
= .003), heterozygous (GG vs CG: OR = 1.44, 95%CI = 1.03–2.02,
P
= .034), dominant (GC+CC vs GG: OR = 1.66, 95%CI = 1.18–2.34,
P
= .004), homozygous (GG vs CC:OR = 2.20, 95%CI = 1.07–4.54,
P
= .033), and recessive models (CC vs GG+CG:OR = 2.05, 95%CI = 1.09–3.85,
P
= .025). An analysis of ethnic subgroups revealed that the
COX
-
2
rs20417 polymorphism was significantly associated with GC susceptibility in Asians under all 5 models (G vs C: OR = 2.22, 95%CI = 1.66–2.96,
P
< .001; GG vs CC: OR = 4.29, 95%CI = 1.94–9.50,
P
< .001; GG vs CG: OR = 1.86, 95%CI = 1.34–2.58,
P
< .001; CC vs GG+CG: OR = 3.73, 95%CI = 1.92–7.24,
P
< .001; GC+CC vs GG: OR = 2.20, 95%CI = 1.65–2.93,
P
< .001).
Helicobacter pylori
positive patients suffered a high risk of GC, compared to
H pylori
negative patients under the dominant model (OR = 3.09, 95%CI = 1.80–5.32,
P
< .001).
Conclusion:
This meta-analysis of 15 case-control studies provides strong evidence that the
COX
-
2
rs20417 polymorphism increases the risk of GC susceptibility in general populations, especially in Asians.
Helicobacter pylori
positive patients and those with the
COX
-
2
rs20417 polymorphism had...