Zhang Qinghua, Guo Shougang, Zhang Xiao, Tang Shi, Shao Wen, Han Xiaojuan, Wang Lu, Du Yifeng
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, People's Republic of China.
Neurol Sci. 2015 Nov;36(11):1987-94. doi: 10.1007/s10072-015-2282-2. Epub 2015 Aug 7.
Alzheimer's disease (AD) and cancer are both prevalent in the elderly. Some epidemiological researches have reported the negative association between AD and cancer, but the results are controversial. The present meta-analysis is aimed to clarify the association between cancer and AD. PubMed, Web of knowledge and the Cochrane library databases were searched for eligible publications. The analysis indicated that history of cancer was associated with a reduced risk of AD (ES 0.62, 95 % CIs 0.53-0.74; p < 0.001), with no significance between-study heterogeneity and publication bias. Similar results were found in subgroup analysis by stratifying variables with education and APOEε4 carriers, years of follow-up and sample size of cases. The negative association was also found in analysis of risk of cancer among patients with AD (ES 0.59, 95 % CIs 0.42-0.82; p = 0.002), but with evidence of between-study heterogeneity and publication bias. In order to identify sources of the heterogeneity, subgroup analysis was performed by stratifying variable with or without education adjusted, sample size of cases and years of follow-up. Negative association was found in all subgroup analysis except in studies with less than 5-year follow-up and with heterogeneity disappeared only in the subgroup analysis stratified with sample size of cases. Our results in the present meta-analysis support the negative association between AD and cancer. But further well-designed perspective studies with strict control of confounding factors are needed to clarify the association between AD and cancer.
阿尔茨海默病(AD)和癌症在老年人中都很常见。一些流行病学研究报告了AD与癌症之间的负相关关系,但结果存在争议。本荟萃分析旨在阐明癌症与AD之间的关联。检索了PubMed、Web of knowledge和Cochrane图书馆数据库以获取符合条件的出版物。分析表明,癌症病史与AD风险降低相关(效应量0.62,95%置信区间0.53 - 0.74;p < 0.001),研究间异质性和发表偏倚均无统计学意义。在按教育程度和APOEε4携带者、随访年限和病例样本量分层变量的亚组分析中也发现了类似结果。在AD患者的癌症风险分析中也发现了负相关(效应量0.59,95%置信区间0.42 - 0.82;p = 0.002),但有研究间异质性和发表偏倚的证据。为了确定异质性来源,按是否调整教育程度、病例样本量和随访年限分层变量进行亚组分析。除随访时间少于5年的研究外,在所有亚组分析中均发现负相关,且仅在按病例样本量分层的亚组分析中异质性消失。我们在本荟萃分析中的结果支持AD与癌症之间的负相关关系。但需要进一步进行设计良好、严格控制混杂因素的前瞻性研究来阐明AD与癌症之间的关联。