Tumor Necrosis Factor Alpha (TNF-α) –308G/A Polymorphism and the Risk of Multiple Myeloma: A Meta-analysis of Pooled Data from 12 Case-control Studies

摘要

Objective: Tumor necrosis factor alpha (TNF-α) is an importantcytokine involved in inflammation, immune response, and otherbiological processes. The association between polymorphism -308G/Ain its promoter and the risk of multiple myeloma (MM) is not clear.Thus, we conducted a meta-analysis to clarify this question.Materials and Methods: Twelve eligible studies, which included 2204MM cases and 3478 controls, were enrolled in our meta-analysis bysearching the PubMed, China National Knowledge Infrastructure,Scopus, Web of Science, and Google Scholar databases up to December2018. The effect of polymorphism -308G/A on MM risk was evaluatedby calculating the pooled odds ratio (OR) and the 95% confidenceinterval (CI). Furthermore, the Q-test and I2 statistical analyses wereused to estimate the degree of heterogeneity. Sensitivity analysiswas conducted to test the robustness of the meta-analysis results.Publication bias was assessed by Egger’s test and visual inspection ofa funnel plot.Results: In the dominant model, -308G/A polymorphism wasassociated with reduced MM risk (OR=0.80, 95% CI: 0.65-0.97), andit also demonstrated a significant protective effect with a pooled ORof 0.82 (95% CI: 0.68-0.99) in the Caucasian subgroup. Because ofthe limited number of individual studies with AA genotype carriers,only eight studies were included in the recessive model, and nosignificant difference was observed. Moreover, the meta-analysis ofthe allele frequency demonstrated that the A allele has a protectiveeffect against MM risk with a pooled OR of 0.83 (95% CI: 0.69-0.99).Sensitivity analysis suggested that the synthesized effect size wasnot influenced by any individual study. Moreover, the Egger’s teststatistical analysis suggested that publication bias was not obvious inthe present analysis.