Liu Haibin, Hua Ying, Zheng Xiangyun, Shen Zhaojun, Luo Hui, Tao Xuejiao, Wang Zhiyi
Department of General Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
PLoS One. 2015 May 29;10(5):e0128501. doi: 10.1371/journal.pone.0128501. eCollection 2015.
Results from observational epidemiologic studies on the relationship between coffee consumption and gastric cancer are inconsistent and inconclusive. To assess the association between coffee consumption and the risk of gastric cancer, we summarized evidence from prospective cohort studies.
Relevant studies were retrieved through computer searches (PubMed, EmBase and the Cochrane Library) and a review of references up to December 2014. The quality of the included studies was evaluated by Newcastle-Ottawa quality assessment scale. We used a meta-analytic approach to estimate overall hazard ratios (HRs) and 95% confidence intervals (CIs) for regular coffee drinkers versus individuals who seldom drank coffee. Sensitivity analysis and subgroup analysis were performed to assess the reliability of our results. A dose-response analysis was performed to assess the risk of gastric cancer based on the level of coffee consumption.
Nine prospective cohort studies involving 1,250,825 participants and 3027 gastric cancer cases were included in this meta-analysis. The pooled HR of gastric cancer for the study-specific regularly versus seldom coffee drinking categories was 1.05 (95% CI, 0.88 to 1.25) with significant heterogeneity across studies (I(2) = 74.0%, P = 0.000). After the sensitivity analysis, three studies were deleted; however the association remained insignificant (HR, 0.99; 95% CI, 0.91 to 1.08). Subgroup analysis by anatomic location showed a risk for coffee consumption associated with cardia cancer (HR, 1.23; 95% CI, 1.04 to 1.45; heterogeneity, I(2) = 36.4, P = 0.207). In the dose-response analysis, there was no significant association between coffee intake (in cups) and the risk of gastric cancer (P for linearity trend and non-linearity > 0.05).
Our meta-analysis demonstrated that coffee consumption was not associated with overall gastric cancer risk; however, coffee consumption may be a risk factor for gastric cardia cancer.
关于咖啡饮用与胃癌之间关系的观察性流行病学研究结果并不一致且尚无定论。为评估咖啡饮用与胃癌风险之间的关联，我们总结了前瞻性队列研究的证据。
通过计算机检索（PubMed、EmBase和Cochrane图书馆）以及查阅截至2014年12月的参考文献来获取相关研究。采用纽卡斯尔-渥太华质量评估量表对纳入研究的质量进行评估。我们使用荟萃分析方法来估计经常喝咖啡者与很少喝咖啡者相比的总体风险比（HR）和95%置信区间（CI）。进行敏感性分析和亚组分析以评估我们结果的可靠性。基于咖啡饮用量进行剂量反应分析以评估胃癌风险。
本荟萃分析纳入了9项涉及1,250,825名参与者和3027例胃癌病例的前瞻性队列研究。特定研究中经常喝咖啡与很少喝咖啡类别相比的胃癌合并HR为1.05（95%CI，0.88至1.25），各研究间存在显著异质性（I(2)=74.0%，P = 0.000）。敏感性分析后，删除了3项研究；然而该关联仍不显著（HR，0.99；95%CI，0.91至1.08）。按解剖部位进行的亚组分析显示咖啡饮用与贲门癌存在关联（HR，1.23；95%CI，1.04至1.45；异质性，I(2)=36.4，P = 0.207）。在剂量反应分析中，咖啡摄入量（杯数）与胃癌风险之间无显著关联（线性趋势和非线性的P>0.05）。
我们的荟萃分析表明，咖啡饮用与总体胃癌风险无关；然而，咖啡饮用可能是贲门癌的一个风险因素。
