Riley Charles A, Marino Michael J, Hawkey Nathan, Lawlor Claire M, McCoul Edward D
Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
Otolaryngol Head Neck Surg. 2016 May;154(5):810-6. doi: 10.1177/0194599816629436. Epub 2016 Feb 23.
Chronic inflammation has been described as a precursor to the development of malignancy in several disease states. However, the relationship of sinonasal tract inflammation to nasopharyngeal carcinoma (NPC) remains poorly defined.
Systematic review of primary studies identified through PubMed, EMBASE, MEDLINE, and Cochrane.
Systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE, EMBASE, and Cochrane databases were queried for English-language studies published between 1980 and 2015. Studies were excluded that did not provide quantitative data on sinonasal tract inflammation such as chronic rhinosinusitis (CRS), allergic rhinitis (AR), or human papillomavirus (HPV) status and NPC. An itemized assessment of the risk of bias was conducted for each included study.
Of the 325 studies identified during systematic review, 5 met the criteria for analysis. The level of evidence of those studies was generally low. There was an increased risk of NPC in patients with a previous diagnosis of CRS or AR. Meta-analysis demonstrated an odds ratio (95% confidence interval [CI]) of 2.35 (2.00-2.76) for all studies. Subgroup analysis of patients with sinonasal inflammation had an odds ratio of 2.39 (95% CI, 2.20-2.60). Patients with AR had an odds ratio of 2.29 (95% CI, 2.06-2.54), while those with CRS had an odds ratio of 2.70 (95% CI, 1.98-3.70).
This systematic review and meta-analysis suggests an association between previous sinonasal inflammatory disease and subsequent NPC. Prospective studies are needed to further examine this relationship.
在多种疾病状态下，慢性炎症已被描述为恶性肿瘤发生的先兆。然而，鼻窦道炎症与鼻咽癌（NPC）之间的关系仍未明确界定。
通过PubMed、EMBASE、MEDLINE和Cochrane对原始研究进行系统评价。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价和荟萃分析。查询MEDLINE、EMBASE和Cochrane数据库，以获取1980年至2015年发表的英文研究。排除那些未提供鼻窦道炎症（如慢性鼻窦炎（CRS）、变应性鼻炎（AR））或人乳头瘤病毒（HPV）状态以及NPC定量数据的研究。对每项纳入研究进行了详细的偏倚风险评估。
在系统评价过程中确定的325项研究中，有5项符合分析标准。这些研究的证据水平普遍较低。既往诊断为CRS或AR的患者患NPC的风险增加。荟萃分析显示，所有研究的比值比（95%置信区间[CI]）为2.35（2.00 - 2.76）。鼻窦炎症患者的亚组分析比值比为2.39（95% CI，2.20 - 2.60）。AR患者的比值比为2.29（95% CI，2.06 - 2.54），而CRS患者的比值比为2.70（95% CI，1.98 - 3.70）。
这项系统评价和荟萃分析表明既往鼻窦炎症性疾病与随后发生的NPC之间存在关联。需要进行前瞻性研究以进一步探究这种关系。
