Meta‐analysis

Background: Number of studies have been performed to evaluate the relationship between the cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) gene variant rs5742909 polymorphism and cervical cancer risk, but the sample size was small and the results were conflicting. This meta-analysis was conducted to comprehensively evaluate the overall association. Methods: PubMed, Web of Science, Embase, China Biology Medical Literature database, China National Knowledge Infrastructure, WanFang, and Weipu databases were searched before July 31, 2018. The strength of associations was assessed using odds ratios (ORs) and 95% confidence intervals (CIs). All of the statistical analyses were conducted using Review Manager 5.3 and Stata 14.0. Results:Eleven studies involved 3899 cases and 4608 controls. Overall, significant association was observed between theCTLA-4 gene variant rs5742909 polymorphism and cervical cancer (T vs C: OR=1.40, 95% CI=1.12–1.76; TT vs CC: OR=2.22, 95% CI= 1.13–4.37; TT vs CT+CC: OR=1.96, 95% CI=1.03–3.74; TT+CT vs CC: OR=1.47, 95% CI=1.14–1.90). In subgroup analysis by ethnic group, a statistically significant association was observed in Asians (T vs C: OR=1.56, 95% CI=1.22–1.99), but not in Caucasians (T vs C: OR=1.19, 95% CI=0.87–1.62). The sensitivity analysis confirmed the reliability and stability of the metaanalysis. Conclusion: our meta-analysis supports that the CTLA-4 gene variant rs5742909 polymorphism might contribute to individual susceptibility to cervical cancer in Asians. Abbreviations: CI = confidence interval, CTLA-4 = cytotoxic T-lymphocyte associated antigen-4, HWE = Hardy–Weinberg equilibrium, NOS = Newcastle–Ottawa scale, OR = odds ratio, PCR = polymerase chain reaction, PCR-RFLP = polymerase chain reaction-restriction fragment length polymorphism, SNP = single nucleotide polymorphism.