Department of aInterventional Radiology, The First People's Hospital of Nantong, Jiangsu, China.
Eur J Gastroenterol Hepatol. 2013 Mar;25(3):373-9. doi: 10.1097/MEG.0b013e32835a870b.
Cigarette smoking has been shown to cause many nonpulmonary cancers, including those of liver, pancreas and bladder. However, results of epidemiologic studies examining the association between smoking and gallbladder cancer (GBC) have been mixed. To clarify the association of cigarette smoking and GBC, we performed a meta-analysis of observational studies.
A literature search was performed using Medline (from 1 January 1966) and Embase (from 1 January 1974), through 31 January 2012, and by manually searching the reference lists of pertinent articles. Summary relative risks (SRRs) with corresponding 95% confidence intervals (CIs) were calculated with a random-effects model.
A total of 11 articles (10 case-control and one prospective cohort studies) were used in this meta-analysis, which is based on a total of 1178 GBC cases. Analysis of 11 studies found that smokers had an increased risk of GBC development, compared with nonsmokers (SRRs 1.45, 95% CIs, 1.11-1.89). There was moderate heterogeneity among studies (Q=18.15, P=0.052, I2 =44.9%). These increased risks were independent of alcohol use and a history of gallstones. No significant publication bias was found.
Although the current evidence supports a positive link between cigarette smoking and risk of gallbladder cancer, additional population-based studies, particularly cohort studies, are needed before definitive conclusions can be drawn.
吸烟已被证实可导致多种非肺部癌症，包括肝癌、胰腺癌和膀胱癌。然而，关于吸烟与胆囊癌（GBC）之间关联的流行病学研究结果却存在差异。为了阐明吸烟与 GBC 之间的关联，我们对观察性研究进行了荟萃分析。
通过 Medline（自 1966 年 1 月 1 日起）和 Embase（自 1974 年 1 月 1 日起）进行文献检索，检索截至 2012 年 1 月 31 日，并通过手动检索相关文章的参考文献列表进行补充。采用随机效应模型计算汇总相对风险（SRR）及其相应的 95%置信区间（CI）。
共有 11 项研究（10 项病例对照研究和 1 项前瞻性队列研究）被纳入本荟萃分析，共计纳入 1178 例 GBC 病例。分析发现，与不吸烟者相比，吸烟者发生 GBC 的风险增加（SRR 1.45，95%CI 1.11-1.89）。研究间存在中度异质性（Q=18.15，P=0.052，I2=44.9%）。这些增加的风险与饮酒和胆囊结石史无关。未发现明显的发表偏倚。
尽管目前的证据支持吸烟与胆囊癌风险之间存在正相关关系，但在得出明确结论之前，还需要开展更多基于人群的研究，特别是队列研究。
