Jin Jie, Yu Mengxia, Hu Chao, Ye Li, Xie Lili, Jin Jin, Chen Feifei, Tong Hongyan
Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China; Myelodysplastic syndromes diagnosis and therapy center, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
PLoS One. 2014 Oct 21;9(10):e110850. doi: 10.1371/journal.pone.0110850. eCollection 2014.
Pesticide exposure has been linked to increased risk of cancer at several sites, but its association with risk of myelodysplastic syndromes (MDS) is still unclear. A meta-analysis of studies published through April, 2014 was performed to investigate the association of pesticide exposure with the risk of MDS.
Studies were identified by searching the Web of Science, Cochrane Library and PubMed databases. Summary odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated using random- or fixed-effect models.
This meta-analysis included 11 case-control studies, all of which demonstrated a correlation between pesticide exposure and a statistically significant increased risk of MDS (OR=1.95, 95% CI 1.23-3.09). In subgroup analyses, patients with pesticide exposure had increased risk of developing MDS if they were living in the Europe or Asia and had refractory anemia (RA) or RA with ringed sideroblasts (RARS). Moreover, in the analysis by specific pesticides, increased risk was associated with exposure to insecticides (OR=1.71, 95% CI 1.22-2.40) but not exposure to herbicides or fungicides.
This meta-analysis supports the hypothesis that exposure to pesticides increases the risk of developing MDS. Further prospective cohort studies are warranted to verify the association and guide clinical practice in MDS prevention.
农药暴露与多个部位患癌风险增加有关,但其与骨髓增生异常综合征(MDS)风险的关联仍不明确。对截至2014年4月发表的研究进行荟萃分析,以调查农药暴露与MDS风险的关联。
通过检索科学网、考克兰图书馆和PubMed数据库来确定研究。使用随机或固定效应模型计算汇总比值比(OR)及相应的95%置信区间(CI)。
该荟萃分析纳入了11项病例对照研究,所有研究均表明农药暴露与MDS风险在统计学上显著增加相关(OR=1.95,95%CI 1.23 - 3.09)。在亚组分析中,如果农药暴露患者生活在欧洲或亚洲且患有难治性贫血(RA)或伴有环形铁粒幼细胞的RA(RARS),则发生MDS的风险增加。此外,在按特定农药进行的分析中,风险增加与接触杀虫剂有关(OR=1.71,95%CI 1.22 - 2.40),但与接触除草剂或杀菌剂无关。
该荟萃分析支持农药暴露会增加患MDS风险这一假说。有必要进行进一步的前瞻性队列研究以验证这种关联,并指导MDS预防的临床实践。