Chen Jing, Gong Ting-Ting, Wu Qi-Jun
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Sci Rep. 2016 Jan 4;6:18766. doi: 10.1038/srep18766.
We performed this meta-analysis of epidemiological studies to comprehensively assess the association between parity and gastric cancer risk, because previous studies have shown conflicting results regarding this topic. Relevant prospective studies were identified by searching the following databases: PubMed, EMBASE, and Web of Science, and random-effects models were used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs). Our search yielded 10 prospective cohort studies involving a total of 6624 gastric cancer cases and 5,559,695 non-cases. The SRRs for ever parity vs. nulliparous and highest vs. lowest parity number were 0.96 (95%CI = 0.87-1.05, I(2) = 0%) and 1.03 (95%CI = 0.94-1.13, I(2) = 0%), respectively. Additionally, the SRR for an increment of one live birth was 1.00 (95%CI = 0.97-1.03, I(2) = 18.6%). These non-significant associations were observed in all subgroups as stratified by the number of gastric cases, follow-up years, geographic location, menopausal status, anatomic subsite of gastric cancer, and adjustment for potential confounders, as well as in sensitivity analyses. Our meta-analysis found no significant association between parity and gastric cancer risk. However, further studies should be conducted to validate our findings and could provide more detailed results by stratifying their findings by Lauren's subtype, histology, and anatomic site, as well as fully adjusting for potential confounding factors.
由于既往研究在该主题上结果相互矛盾，我们进行了这项流行病学研究的荟萃分析，以全面评估生育与胃癌风险之间的关联。通过检索以下数据库来识别相关的前瞻性研究：PubMed、EMBASE和Web of Science，并使用随机效应模型来估计汇总相对风险（SRR）和95%置信区间（CI）。我们的检索得到了10项前瞻性队列研究，总共涉及6624例胃癌病例和5559695例非病例。曾经生育与未生育相比以及生育数最高与最低相比的SRR分别为0.96（95%CI = 0.87 - 1.05，I² = 0%）和1.03（95%CI = 0.94 - 1.13，I² = 0%）。此外，每增加一次活产的SRR为1.00（95%CI = 0.97 - 1.03，I² = 18.6%）。在按胃癌病例数、随访年限、地理位置、绝经状态、胃癌的解剖部位分层以及对潜在混杂因素进行调整的所有亚组中，以及在敏感性分析中，均观察到这些无显著意义的关联。我们的荟萃分析发现生育与胃癌风险之间无显著关联。然而，应开展进一步研究以验证我们的发现，并可通过按劳伦分型、组织学和解剖部位对结果进行分层，以及对潜在混杂因素进行充分调整，从而提供更详细的结果。
