Qadeer Mohammed A, Colabianchi Natalie, Vaezi Michael F
Department of Internal Medicine, Cleveland Clinic Foundation, Case Western Reserve University, Cleveland, Ohio, USA.
Laryngoscope. 2005 Mar;115(3):486-91. doi: 10.1097/01.mlg.0000157851.24272.41.
OBJECTIVE/HYPOTHESIS: The significance of gastroesophageal reflux disease (GERD) in laryngeal cancer is controversial due to disparate studies. To evaluate the overall strength of the association of GERD with laryngeal cancer, we performed meta-analysis of the original studies in literature.
Meta-analysis.
All studies cited on Ovid Medline (1966-June 2004), EMBASE (1980-June 2004), and Cochrane database describing GERD and laryngeal cancer were eligible for inclusion. The inclusion criteria for the study included original controlled study design and a clear documentation of the reflux prevalence in cases and controls. Statistical analysis was performed by NCSS software.
Fifteen original studies were identified. Eight studies did not have control groups, two studies did not clearly document GERD prevalence in controls, and two studies were published using the same data, one of which was included in this meta-analysis. Thus, four studies qualified for inclusion for the meta-analysis. The methodologic quality in the studies was heterogeneous, not only in the evaluation of confounding risk factors such as smoking and alcohol but also in the mode of GERD diagnosis. There was also significant heterogeneity of effect of reflux among the studies (P = .001). The pooled odds ratio on the basis of fixed-effects model was 2.86 (95% CI, 2.73-2.99), and on the basis of random-effects model was 2.37 (95% CI 1.38-4.08).
Our meta-analysis suggests that GERD may be a significant risk factor for laryngeal cancer. However, given the heterogeneity of the published data, future prospective controlled studies are needed.
目的/假设：由于研究结果存在差异，胃食管反流病（GERD）在喉癌中的意义存在争议。为了评估GERD与喉癌关联的总体强度，我们对文献中的原始研究进行了荟萃分析。
荟萃分析。
纳入所有在Ovid Medline（1966年 - 2004年6月）、EMBASE（1980年 - 2004年6月）和Cochrane数据库中被引用的描述GERD和喉癌的研究。该研究的纳入标准包括原始对照研究设计以及病例组和对照组中反流患病率的清晰记录。使用NCSS软件进行统计分析。
共识别出15项原始研究。8项研究没有对照组，2项研究未明确记录对照组中的GERD患病率，2项研究使用相同数据发表，其中一项被纳入本荟萃分析。因此，有4项研究符合荟萃分析的纳入标准。这些研究的方法学质量存在异质性，不仅在吸烟和饮酒等混杂危险因素的评估方面，而且在GERD诊断方式上。研究之间反流效应也存在显著异质性（P = .001）。基于固定效应模型的合并比值比为2.86（95%可信区间，2.73 - 2.99），基于随机效应模型的合并比值比为2.37（95%可信区间1.
