Gong Yuhua, Wei Benjuan, Yu Li, Pan Weijuan
Department of Stomatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Stomatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Oral Oncol. 2015 Apr;51(4):332-40. doi: 10.1016/j.oraloncology.2015.01.003. Epub 2015 Jan 31.
Associations between type 2 diabetes mellitus (type 2 DM) and risk of oral cancer and precancerous lesions have been reported with controversial findings. We performed a meta-analysis to explore these associations.
We identified studies by a literature search of MEDLINE and EMBASE through May 31, 2014, and by searching the reference lists of pertinent articles. Summary relative risk (SRR) with 95% confidence interval (CI) was calculated with a random-effects model. Between- study heterogeneity was assessed using the Cochran's Q and I(2) statistics.
A total of 13 studies (4 case-control and 9 cohort studies) on the association between type 2 DM and oral cancer were included. Overall analysis found that compared with non-diabetic individuals, individuals with type 2 DM had a significantly elevated incidence of oral cancer (SRR=1.15, 95% CI: 1.02-1.29; Pheterogeneity=0.277, I(2)=15.4%; 10 studies). Subgroup analyses found that duration of follow-up (⩾11years) significantly altered this positive association. Type 2 DM was associated with increased oral cancer mortality (SRR=1.41, 95% CI: 1.16-1.72; 4 studies). Meta-analysis of the four case-control studies showed a positive association between type 2 DM and risk of oral precancerous lesions (SRR=1.85, 95%CI: 1.23-2.80; Pheterogeneity=0.038, I(2)=57.5%). No significant public bias was found across these studies.
These findings of this meta-analysis indicate that compared with non-diabetic individuals, individuals with type 2 DM have an elevated risk of oral cancer and precancerous lesions development.
2型糖尿病（2型DM）与口腔癌及癌前病变风险之间的关联已有报道，但结果存在争议。我们进行了一项荟萃分析以探讨这些关联。
通过检索MEDLINE和EMBASE至2014年5月31日的文献，并搜索相关文章的参考文献列表来确定研究。采用随机效应模型计算95%置信区间（CI）的汇总相对风险（SRR）。使用Cochran's Q和I²统计量评估研究间的异质性。
共纳入13项关于2型DM与口腔癌关联的研究（4项病例对照研究和9项队列研究）。总体分析发现，与非糖尿病个体相比，2型DM患者口腔癌发病率显著升高（SRR = 1.15，95%CI：1.02 - 1.29；P异质性 = 0.277，I² = 15.4%；10项研究）。亚组分析发现随访时间（≥11年）显著改变了这种正相关关系。2型DM与口腔癌死亡率增加相关（SRR = 1.41，95%CI：1.16 - 1.72；4项研究）。对4项病例对照研究的荟萃分析显示，2型DM与口腔癌前病变风险呈正相关（SRR = 1.85，95%CI：1.23 - 2.80；P异质性 = 0.038，I² = 57.5%）。这些研究中未发现明显的发表偏倚。
这项荟萃分析的结果表明，与非糖尿病个体相比，2型DM患者发生口腔癌及癌前病变的风险升高。
