Bravi Francesca, Bosetti Cristina, Tavani Alessandra, Bagnardi Vincenzo, Gallus Silvano, Negri Eva, Franceschi Silvia, La Vecchia Carlo
Laboratorio di Epidemiologia, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Hepatology. 2007 Aug;46(2):430-5. doi: 10.1002/hep.21708.
Several studies suggest an inverse relation between coffee drinking and risk of hepatocellular carcinoma (HCC). We conducted a meta-analysis of published studies on HCC that included quantitative information on coffee consumption. Ten studies were retrieved (2,260 HCC cases), including 6 case-control studies from southern Europe and Japan (1551 cases) and 4 cohort studies from Japan (709 cases). The summary relative risk (RR) for coffee drinkers versus non-drinkers was 0.54 (95% confidence interval [CI] 0.38-0.76) for case-control studies and 0.64 (95% CI 0.56-0.74) for cohort studies. The overall RR was 0.59 (95% CI 0.49-0.72), with significant heterogeneity between studies. The overall summary RR for low or moderate coffee drinkers was 0.70 (95% CI 0.57-0.85), and that for high drinkers was 0.45 (95% CI 0.38-0.53). The summary RR for an increase of 1 cup of coffee per day was 0.77 (95% CI 0.72-0.83) from case-control studies, 0.75 (95% CI 0.65-0.85) from cohort studies, and 0.77 (95% CI 0.72-0.82) overall. The consistency of an inverse relation between coffee drinking and HCC across study design and geographic areas weighs against a major role of bias or confounding. Coffee drinking has also been related to reduced risk of other liver diseases, thus suggesting a continuum of the favorable effect of coffee on liver function. However, subjects with liver conditions may selectively reduce their coffee consumption.
The present analysis provides evidence that the inverse relation between coffee and HCC is real, though inference on causality remains open to discussion.
多项研究表明咖啡饮用与肝细胞癌（HCC）风险之间存在负相关关系。我们对已发表的关于HCC的研究进行了荟萃分析，这些研究包含了咖啡摄入量的定量信息。检索到10项研究（2260例HCC病例），包括来自南欧和日本的6项病例对照研究（1551例病例）以及来自日本的4项队列研究（709例病例）。病例对照研究中，咖啡饮用者与非饮用者的汇总相对风险（RR）为0.54（95%置信区间[CI] 0.38 - 0.76），队列研究中为0.64（95% CI 0.56 - 0.74）。总体RR为0.59（95% CI 0.49 - 0.72），研究之间存在显著异质性。低或中度咖啡饮用者的总体汇总RR为0.70（95% CI 0.57 - 0.85），高饮用者为0.45（95% CI 0.38 - 0.53）。病例对照研究中，每天多喝1杯咖啡的汇总RR为0.77（95% CI 0.72 - 0.83），队列研究中为0.75（95% CI 0.65 - 0.85），总体为0.77（95% CI 0.72 - 0.82）。跨研究设计和地理区域，咖啡饮用与HCC之间负相关关系的一致性不利于偏倚或混杂因素起主要作用。咖啡饮用还与其他肝脏疾病风险降低有关，因此提示咖啡对肝功能的有益作用具有连续性。然而，患有肝脏疾病的受试者可能会选择性减少咖啡摄入量。
本分析提供了证据表明咖啡与HCC之间的负相关关系是真实的，尽管关于因果关系的推断仍有待讨论。
