Wang Y, Zhang F-C, Wang Y-J
Postgraduate Training Base of the General Hospital of Jinan Military Command, Liaoning Medical University, Jinan, Shandong, China.
Colorectal Dis. 2015 Mar;17(3):188-96. doi: 10.1111/codi.12838.
We report a meta-analysis and systematic review of randomized trials assessing the impact of non-steroidal anti-inflammatory drugs (NSAIDs) in preventing recurrence of colorectal adenoma.
PubMed/Medicine, EMBASE and the Cochrane Central Register of Controlled Trials databases were searched for relevant randomized double-blind placebo-controlled trials published before March 2014. Two authors independently assessed study quality and extracted data. stata software was used to investigate heterogeneity between studies, and analysis was performed using a fixed-effects model to calculate and merge data.
Nine studies, with 8521 subjects, were included. Results were categorized by the duration of follow-up. The relative risks of any recurrence of adenoma in patients receiving NSAIDs compared with the placebo group were 0.68 [95% confidence interval (CI) 0.63-0.73, P = 0.001] for patients with a 1-year follow-up, 0.75 (95% CI 0.68-0.83, P = 0.246) with 3 years and 1.43 (95% CI 1.14-1.79, P = 0.127) with follow-up of over 3 years. Using pooled risk ratios, NSAIDs were associated with a significant decrease in adenoma recurrence at 1 and 3 years, although this association was lost beyond 3 years of follow-up. For secondary prevention of advanced adenomas, the pooled risk ratios (compared with placebo) were 0.51 (95% CI 0.43-0.60, P = 0.026) after 1 year, 0.61 (95% CI 0.50-0.76, P = 0.887) at 3 years and 1.39 (95% CI 0.89-2.16, P = 0.829) after 3 years.
The meta-analysis indicated that oral NSAIDs may be effective in the early prevention of secondary occurrence of adenomas.
我们报告一项荟萃分析及系统评价，该分析评估了非甾体抗炎药（NSAIDs）在预防结直肠腺瘤复发方面的作用，纳入了随机试验。
检索了PubMed/医学、EMBASE和Cochrane对照试验中心注册库数据库，以查找2014年3月之前发表的相关随机双盲安慰剂对照试验。两位作者独立评估研究质量并提取数据。使用Stata软件研究各研究之间的异质性，并采用固定效应模型进行分析以计算和合并数据。
纳入9项研究，共8521名受试者。结果按随访时间分类。接受NSAIDs治疗的患者与安慰剂组相比，腺瘤任何复发的相对风险在随访1年的患者中为0.68[95%置信区间（CI）0.63 - 0.73，P = 0.001]，随访3年时为0.75（95%CI 0.68 - 0.83，P = 0.246），随访超过3年时为1.43（95%CI 1.14 - 1.79，P = 0.127）。使用合并风险比，NSAIDs在1年和3年时与腺瘤复发显著降低相关，尽管在随访超过3年后这种相关性消失。对于晚期腺瘤的二级预防，合并风险比（与安慰剂相比）在1年后为0.51（95%CI 0.43 - 0.60，P = 0.026），3年时为0.61（95%CI 0.50 - 0.76，P = 0.887），3年后为1.39（95%CI 0.89 - 2.16，P = 0.829）。
荟萃分析表明，口服NSAIDs可能在早期预防腺瘤二次发生方面有效。
