Department of Gastroenterology, Changhai Hospital of Second Military Medical University, Shanghai 200433, China.
Cancer Causes Control. 2012 Feb;23(2):263-72. doi: 10.1007/s10552-011-9874-9. Epub 2011 Nov 18.
Inconsistent findings from observational studies have prolonged the controversy over the effects of history of diabetes mellitus (DM) on the risk of esophageal cancer (EC). We conducted a meta-analysis of epidemiologic studies to evaluate the association of a history of DM with the risk of EC.
We identified studies by a literature search of MEDLINE (from 1 January 1966) and EMBASE (from 1 January 1974), through 28 Feburary 2011, and by searching the reference lists of pertinent articles. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. All statistical tests were two-sided.
A total of 17 studies (6 case-control studies and 11 cohort studies) fulfilled the inclusion and exclusion criteria. Compared with non-diabetic individuals, diabetic individuals had a modestly increased risk of EC (SRRs 1.30, 95% CI: 1.12-1.50), with significant heterogeneity among studies (p = 0.042). In stratified analysis, the SRRs of EC were 1.28 (1.10-1.49) for diabetic men and 1.07 (95% CI, 0.71-1.62) for diabetic women, respectively. In addition, DM was associated with an increased risk of esophageal adenocarcinoma (SRR 2.12, 95% CI 1.01-4.46). There was no significant publication bias (p = 0.127 for Begg's adjusted rank correlation test and p = 0.629 for Egger's regression test).
These findings support the hypothesis that men with diabetes may have a modestly increased risk of EC, while diabetic women were not the case.
来自观察性研究的不一致结果延长了糖尿病（DM）病史对食管癌（EC）风险影响的争议。我们对流行病学研究进行了荟萃分析，以评估 DM 病史与 EC 风险之间的关联。
我们通过对 MEDLINE（1966 年 1 月 1 日）和 EMBASE（1974 年 1 月 1 日）的文献搜索，以及截止到 2011 年 2 月 28 日的搜索，确定了研究。通过搜索相关文章的参考文献列表进行补充。使用随机效应模型计算汇总相对风险（SRR）及其 95%置信区间（CI）。所有统计检验均为双侧检验。
共有 17 项研究（6 项病例对照研究和 11 项队列研究）符合纳入和排除标准。与非糖尿病个体相比，糖尿病个体患 EC 的风险略有增加（SRR 1.30，95%CI：1.12-1.50），研究间存在显著异质性（p = 0.042）。在分层分析中，男性糖尿病患者的 EC 的 SRR 为 1.28（1.10-1.49），女性糖尿病患者的 EC 的 SRR 为 1.07（95%CI，0.71-1.62）。此外，DM 与食管腺癌（SRR 2.12，95%CI 1.01-4.46）的风险增加相关。未发现明显的发表偏倚（Begg 调整等级相关检验的 p = 0.127，Egger 回归检验的 p = 0.629）。
这些发现支持以下假设：男性糖尿病患者可能有适度增加患 EC 的风险，而女性糖尿病患者则不然。
