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乳腺癌发病率与镉暴露:一项荟萃分析及系统评价

Breast cancer frequency and exposure to cadmium: a meta- analysis and systematic review.

作者信息

Rahim Fakher, Jalali Amir, Tangestani Raheleh

机构信息

Toxicology Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Asian Pac J Cancer Prev. 2013;14(7):4283-7. doi: 10.7314/apjcp.2013.14.7.4283.

DOI:10.7314/apjcp.2013.14.7.4283
PMID:23991990
Abstract

BACKGROUND

In this meta-analysis we review evidence suggesting that exposure to cadmium is a cause of breast cancer.

MATERIALS AND METHODS

We conducted Medline/PubMed and Scopus searches using selected MeSH keywords to identify papers published from January 1, 1980 through January 1, 2013. Data were merged and summary mean differences were estimated using either a random-effects model or a fixed-effects model.

RESULTS

There were 13 studies including 978 exposed cases and 1,279 controls. There was no statistically significant difference in the frequencies of breast cancer between cadmium-exposed and control groups, and the summary estimate of mean difference was 0.71 (95%CI: 0.33-1.08). However, stratification showed that there were statistically significant differences in the frequencies of breast cancer between cadmium-exposed and control groups among Asian compared with Caucasian population, and the summary estimates of mean difference were 1.45 (95%CI: 0.62-2.28) vs. 0.25 (95%CI: -0.09-0.6), respectively. There was a difference in the frequencies of breast cancer between cadmium-exposed and control groups in peripheral venous blood sampling methods, and the summary estimate of mean difference was 1.41 (95%CI: 0.46-2.37).

CONCLUSIONS

Data indicate that the frequencies of breast cancer might be an indicator of early genetic effects for cadmium-exposed populations. However, our meta-analysis was performed on population-based studies; meta-analysis based on individual data might provide more precise and reliable results. Therefore, it is necessary to construct an international database on genetic damage among populations exposed to cadmium that may contain all raw data of studies examining genetic toxicity.

摘要

背景

在这项荟萃分析中,我们回顾了表明接触镉是乳腺癌病因的证据。

材料与方法

我们使用选定的医学主题词(MeSH)关键词在Medline/PubMed和Scopus数据库中进行检索,以识别1980年1月1日至2013年1月1日发表的论文。合并数据并使用随机效应模型或固定效应模型估计汇总平均差异。

结果

共有13项研究,包括978例暴露病例和1279例对照。镉暴露组和对照组之间乳腺癌的发病率没有统计学上的显著差异,平均差异的汇总估计值为0.71(95%置信区间:0.33 - 1.08)。然而,分层分析显示,与白种人群相比,亚洲人群中镉暴露组和对照组之间乳腺癌的发病率存在统计学上的显著差异,平均差异的汇总估计值分别为1.45(95%置信区间:0.62 - 2.28)和0.25(95%置信区间: - 0.09 - 0.6)。外周静脉血采样方法中镉暴露组和对照组之间乳腺癌的发病率存在差异,平均差异的汇总估计值为1.41(95%置信区间:0.46 - 2.37)。

结论

数据表明,乳腺癌的发病率可能是镉暴露人群早期遗传效应的一个指标。然而,我们的荟萃分析是基于人群研究进行的;基于个体数据的荟萃分析可能会提供更精确和可靠的结果。因此,有必要构建一个关于镉暴露人群遗传损伤的国际数据库,该数据库可能包含所有检测遗传毒性研究的原始数据。

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