Keramatinia Aliasghar, Hassanipour Soheil, Nazarzadeh Milad, Wurtz Morten, Monfared Ayad Bahadori, Khayyamzadeh Maryam, Bidel Zeinab, Mhrvar Narges, Mosavi-Jarrahi Alireza
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
Asian Pac J Cancer Prev. 2016;17(1):419-24. doi: 10.7314/apjcp.2016.17.1.419.
The aim of this systematic review was to study the relationship between exposure to nitrogen dioxide (NO2) in the ambient air and breast cancer incidence.
A systematic review was performed based on the MOOSE guideline for review of observational studies. We searched five online databases (PubMed, Science Direct, Google Scholar, EBSCO, and Scopus) from their conception to June 2014. A pooled estimate of the correlation between NO2 exposure and breast cancer incidence was calculated using Pearson's correlation coefficient.
A total of 654 titles were retrieved in the initial search of the databases. Further refinement and screening of the retrieved studies produced a total of five studies from four countries. The studies included three ecological studies (aggregate level) and two individual based studies (one prospective cohort and the other one a case-control study). The ecological studies were pooled and the meta-analysis of correlation coefficient without z transformation showed a pooled estimate of r = 0.89 with 95% CI of 0.84 to 0.95. Using z transformation, the pooled r was 1.38 with 95%CI of 1.11 to 1.59. No significant heterogeneity between studies was observed. Following a sensitivity analysis and the removal of each study from pooled analysis we did not see any significant change in the pooled estimate.
It was concluded that there is a tendency toward a weak association between exposure to NO2 in ambient air and breast cancer at the individual level and a significant association at the aggregate level.
本系统评价的目的是研究环境空气中二氧化氮（NO₂）暴露与乳腺癌发病率之间的关系。
根据MOOSE观察性研究评价指南进行系统评价。我们检索了五个在线数据库（PubMed、Science Direct、谷歌学术、EBSCO和Scopus），检索时间从建库至2014年6月。使用Pearson相关系数计算NO₂暴露与乳腺癌发病率之间相关性的合并估计值。
在数据库的初始检索中总共检索到654篇文献。对检索到的研究进行进一步筛选后，最终纳入了来自四个国家的五项研究。这些研究包括三项生态学研究（总体水平）和两项基于个体的研究（一项前瞻性队列研究和另一项病例对照研究）。对生态学研究进行合并，未进行z转换的相关系数荟萃分析显示合并估计值r = 0.89，95%置信区间为0.84至0.95。使用z转换后，合并的r为1.38，95%置信区间为1.11至1.59。未观察到研究之间存在显著异质性。在进行敏感性分析并从合并分析中剔除每项研究后，我们发现合并估计值没有任何显著变化。
得出的结论是，在个体水平上，环境空气中NO₂暴露与乳腺癌之间存在弱关联趋势，而在总体水平上存在显著关联。
