title: Association of cytotoxic T lymphocyte antigen-4 +49A/G polymorphism and cancer risk: An updated meta-analysis.
abstract: BACKGROUND
  Associations between cytotoxic T lymphocyte antigen-4 (CTLA-4) +49A/G polymorphism and cancer risk are inconclusive. We performed this meta-analysis to derive a more precise estimation of the relationship.
  
  
  METHODS
  A comprehensive literature search was performed using electronic databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association.
  
  
  RESULTS
  A total of 16,358 cases and 19,737 controls from 46 studies were included. Overall, significant association between CTLA-4 +49A/G polymorphism and cancer risk was observed in all genetic models (G vs. A: OR=0.88, 95%CI=0.83-0.93, PH=0.000; GA vs. AA: OR=0.87, 95%CI=0.79-0.97, PH=0.000; GG vs. AA: OR=0.75, 95%CI= 0.65-0.86, PH=0.000; GG vs. GA+AA: OR=0.84, 95%CI=0.79-0.91, PH=0.001; GG+GA vs. AA: OR=0.83, 95%CI=0.74-0.92, PH=0.000). Stratified analysis by cancer type revealed that the CTLA-4+49A/G polymorphism is associated with the decreased risk of cervical cancer, breast cancer, lung cancer, HCC. Further subgroup analysis by ethnicity indicated that there was a statistically decreased cancer risk in Asian population.
  
  
  CONCLUSIONS
  This meta-analysis suggests that CTLA-4+49A/G polymorphism is associated with cancer risk, especially in Asian population.
authors.affiliation: Department of Microbiology and Immunology, Medical College of Southeast University, Nanjing, Jiangsu, China.
authors.forename: Xueren
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of General Surgery, Zhongda Hospital, Southeast University Medical School, Nanjing, Jiangsu, China.
authors.forename: Shulong
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan, China.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Qiao
authors.affiliation: Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan, China.
authors.forename: Limin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Dong
authors.affiliation: Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan, China.
authors.forename: Xinxiu
authors.initials: X
authors.lastname: Ma
authors.affiliation: Women and Infants Hospital of Zhengzhou, Zhengzhou, Henan, China.
authors.forename: Taosheng
authors.initials: T
authors.lastname: Wang
mesh_terms: D060908:CTLA-4 Antigen / Q000235:genetics*; D016022:Case-Control Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D009369:Neoplasms / Q000235:genetics* / Q000276:immunology*; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human
keywords: \CTLA-4; cancer risk; meta-analysis; polymorphism