Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China.
Int J Cancer. 2013 Jul 15;133(2):473-85. doi: 10.1002/ijc.28024. Epub 2013 Feb 13.
Quantification of the association between the intake of fruit and vegetables and risk of esophageal squamous cell carcinoma (ESCC) is controversial even though several studies have explored this association. We summarized the evidence from observational studies in categorical, linear and non-linear dose-response meta-analyses. Eligible studies published up to 31 July 2012 were retrieved via computer searches of MEDLINE and EMBASE as well as manual review of references. Random-effects models were used to calculate summary relative risks (SRRs) and the corresponding 95% confidence intervals (CIs). A total of 32 studies involving 10,037 cases of ESCC were included in this meta-analysis. The SRRs for the highest vs. lowest intake were 0.56 (95% CI: 0.45-0.69) for vegetable intake and 0.53 (95% CI: 0.44-0.64) for fruit intake (pheterogeneity <0.001 for both). Similar results were observed in a linear dose-response analysis. There was evidence of non-linear associations for intakes of fruit (pnon-linearity <0.001) and vegetables (pnon-linearity =0.041). There was no evidence of publication bias. These data support the hypothesis that intakes of vegetables and fruit may significantly reduce the risk of ESCC. Further investigation with prospective designs, validated questionnaires and good control of important confounders is warranted.
尽管已有多项研究探讨了水果和蔬菜摄入量与食管鳞状细胞癌（ESCC）风险之间的关系，但水果和蔬菜摄入量与 ESCC 风险之间的关联仍存在争议。我们对观察性研究进行了分类、线性和非线性剂量反应荟萃分析，对证据进行了总结。通过计算机检索 MEDLINE 和 EMBASE，并手动查阅参考文献，检索了截至 2012 年 7 月 31 日发表的合格研究。使用随机效应模型计算汇总相对风险（SRR）和相应的 95%置信区间（CI）。共有 32 项研究纳入了 10037 例 ESCC 病例，进行了这项荟萃分析。最高与最低摄入量相比，蔬菜摄入量的 SRR 为 0.56（95%CI：0.45-0.69），水果摄入量的 SRR 为 0.53（95%CI：0.44-0.64）（两者的异质性检验 p<0.001）。线性剂量反应分析也观察到了类似的结果。水果摄入量（p<0.001）和蔬菜摄入量（p=0.041）呈非线性关联。没有发表偏倚的证据。这些数据支持这样的假设，即蔬菜和水果的摄入可能显著降低 ESCC 的风险。需要进一步进行前瞻性设计、验证的问卷和对重要混杂因素的良好控制的研究。
