Li Bailing, Jiang Gengxi, Zhang Guanxin, Xue Qing, Zhang Hao, Wang Chong, Zhao Tiejun
Department of Cardiothoracic Surgery, Changhai Hospital of Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
Eur J Nutr. 2014 Oct;53(7):1511-21. doi: 10.1007/s00394-014-0656-5. Epub 2014 Jan 22.
To study the association between the intake of fruit and vegetables and risk of esophageal adenocarcinoma (EAC), we summarized the evidence from observational studies in categorical and linear dose-response meta-analyses.
Eligible studies published up to June 2013 were retrieved via computerized searches of MEDLINE and EMBASE. Random-effects models were used to calculate summary relative risks (SRRs) and the corresponding 95% confidence intervals (CIs). Between-study heterogeneity was assessed using the Cochran's Q and I (2) statistics.
A total of 12 studies involving 1,572 cases of EAC were included in this meta-analysis. Based on the highest versus lowest analysis, inverse associations were observed between intakes of vegetable (SRRs = 0.76, 95% CIs 0.59-0.96; P heterogeneity = 0.098, I (2) 40.4%; n = 9 studies), intakes of fruit (SRRs = 0.73, 95% CIs, 0.55-0.98; P heterogeneity = 0.03, I (2) = 52.9%; n = 9 studies), and intakes of total vegetables and fruit combined (SRRs = 0.68, 95% CI 0.49-0.93; P heterogeneity = 0.162, I (2) = 38.9%; n = 5 studies). Similar results were also observed in a linear dose-response analysis.
These data support the hypothesis that intakes of vegetables and fruit may significantly reduce the risk of EAC. Further investigation with prospective designs, validated questionnaires, and good control of important confounders is warranted.
为研究水果和蔬菜摄入量与食管腺癌（EAC）风险之间的关联，我们在分类和线性剂量反应荟萃分析中总结了观察性研究的证据。
通过对MEDLINE和EMBASE进行计算机检索，获取截至2013年6月发表的符合条件的研究。采用随机效应模型计算汇总相对风险（SRR）及相应的95%置信区间（CI）。使用Cochran's Q和I²统计量评估研究间的异质性。
该荟萃分析共纳入12项研究，涉及1572例EAC病例。基于最高摄入量与最低摄入量的分析，蔬菜摄入量（SRR = 0.76，95% CI 0.59 - 0.96；P异质性 = 0.098，I² = 40.4%；n = 9项研究）、水果摄入量（SRR = 0.73，95% CI 0.55 - 0.98；P异质性 = 0.03，I² = 52.9%；n = 9项研究）以及蔬菜和水果总摄入量（SRR = 0.68，95% CI 0.49 - 0.93；P异质性 = 0.162，I² = 38.9%；n = 5项研究）之间均观察到负相关。在线性剂量反应分析中也观察到类似结果。
这些数据支持蔬菜和水果摄入量可能显著降低EAC风险这一假设。有必要采用前瞻性设计、经过验证的问卷并良好控制重要混杂因素进行进一步研究。
