The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Sydney Medical School, Nepean, Penrith, NSW, Australia.
Aliment Pharmacol Ther. 2012 Oct;36(8):708-16. doi: 10.1111/apt.12041. Epub 2012 Sep 11.
Bisphoshonates, which are used in the treatment and prevention of osteoporosis, have recently been implicated in the development of oesophageal cancer; however, studies report conflicting data.
To conduct a meta-analysis of studies reporting on the association between bisphosphonates and oesophageal cancer to quantify the relationship.
A search was conducted through Medline, PubMed, Embase and Current Contents Connect to 2 August 2012. We calculated pooled odds ratios and 95% CIs using a random effects model for the risk of oesophageal cancer associated with exposure to bisphosphonates, as well as for the different periods of exposure.
Seven studies, with 19 700 oesophageal cancer cases, met our inclusion criteria. We found a positive relationship between exposure to bisphosphonates and oesophageal cancer, with an odds ratio (OR) of 1.74 with a 95% CI of 1.19-2.55. Heterogeneity was observed (I(2 ) = 85%, P < 0.001). Publication bias was not present. An increased risk of oesophageal cancer was also found in the group exposed to bisphosphonates for a longer period of time, compared with the group who experienced a shorter period of exposure (OR 2.32; 95% CI 1.57-3.43 vs. OR 1.35; 95% CI 0.77-2.39). An increased risk was associated with exposure to Etidronate (OR 1.58; 95% CI 1.12-2.24), but not to Aledronate.
Exposure to bisphosphonates may be associated with an increased risk of oesophageal cancer. More studies are needed to confirm the relationship.
双膦酸盐类药物被广泛应用于骨质疏松的治疗和预防，最近被发现与食道癌的发生有关；然而，研究结果存在差异。
对报告双膦酸盐类药物与食道癌相关性的研究进行荟萃分析，以定量评估两者的关系。
检索 Medline、PubMed、Embase 和 Current Contents Connect 数据库，检索时间截至 2012 年 8 月 2 日。我们采用随机效应模型计算了双膦酸盐暴露与食道癌风险的比值比（OR）及其 95%可信区间（CI），并对不同暴露时间进行了分析。
共有 7 项研究（包含 19700 例食道癌病例）符合纳入标准。我们发现，双膦酸盐暴露与食道癌之间存在正相关关系，OR 为 1.74，95%CI 为 1.19-2.55。存在异质性（I(2) = 85%，P < 0.001）。不存在发表偏倚。与短期暴露组相比，长期暴露组发生食道癌的风险更高（OR 2.32，95%CI 1.57-3.43 与 OR 1.35，95%CI 0.77-2.39）。与 Aledronate 相比，Etidronate 暴露与更高的风险相关（OR 1.58，95%CI 1.12-2.24）。
双膦酸盐类药物的暴露可能与食道癌风险增加相关。需要进一步研究来证实这种关系。
