Gandini Sara, Lowenfels Albert B, Jaffee Elizabeth M, Armstrong Todd D, Maisonneuve Patrick
Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1908-16. doi: 10.1158/1055-9965.EPI-05-0119.
Previous reports suggest that allergic disorders may protect against various types of cancer, but the association between history of allergy and pancreatic cancer risk has not been well studied. We did a systematic review and meta-analysis of published studies to evaluate the association of any type, and specific types, of allergy and the risk of pancreatic cancer. We did a comprehensive literature search using MEDLINE, PUBMED, and the ISI Web of Science databases to identify potential relevant case-control and cohort studies. Pooled relative risks (RR) and 95% confidence intervals (95% CI) were calculated using the fixed- and random-effects model. Fourteen population-based studies (4 cohort and 10 case-control studies) with a total of 3,040 pancreatic cancer cases fulfilled our inclusion criteria. A history of allergy was associated with a reduced risk of pancreatic cancer (RR, 0.82; 95% CI, 0.68-0.99). The risk reduction was stronger for allergies related to atopy (RR, 0.71; 95% CI, 0.64-0.80), but not for asthma (RR, 1.01; 95% CI, 0.77-1.31). There was no association between allergies related to food or drugs and pancreatic cancer (RR, 1.08; 95% CI, 0.74-1.58). Overall, there was no evidence of publication bias. Allergies, in particular those related to atopy, seem to be associated with a decreased risk of pancreatic cancer. The hyperactive immune system of allergic individuals may, therefore, in some way lead to increased surveillance and protect against pancreatic cancer development.
既往报告提示,过敏性疾病可能对多种类型的癌症具有预防作用,但过敏史与胰腺癌风险之间的关联尚未得到充分研究。我们对已发表的研究进行了一项系统评价和荟萃分析,以评估任何类型以及特定类型的过敏与胰腺癌风险之间的关联。我们使用MEDLINE、PUBMED和ISI科学网数据库进行了全面的文献检索,以识别潜在的相关病例对照研究和队列研究。采用固定效应模型和随机效应模型计算合并相对风险(RR)及95%置信区间(95%CI)。共有14项基于人群的研究(4项队列研究和10项病例对照研究)、总计3040例胰腺癌病例符合我们的纳入标准。过敏史与胰腺癌风险降低相关(RR,0.82;95%CI,0.68 - 0.99)。与特应性相关的过敏导致的风险降低更为显著(RR,0.71;95%CI,0.64 - 0.80),但哮喘并非如此(RR,1.01;95%CI,0.77 - 1.31)。与食物或药物相关的过敏与胰腺癌之间无关联(RR,1.08;95%CI,0.74 - 1.58)。总体而言,无发表偏倚的证据。过敏,尤其是与特应性相关的过敏,似乎与胰腺癌风险降低相关。因此,过敏个体的免疫系统亢进可能在某种程度上导致监测增加并预防胰腺癌的发生。