Zhao Tai-Yun, Tu Jing, Wang Yin, Cheng Da-Wei, Gao Xian-Kui, Luo Hao, Yan Bi-Chun, Xu Xiao-Li, Zhang Hong-Ling, Lu Xing-Jun, Wang Yao-Jun
Department of Gastroenterology, The people,s hospital of BoZHou Anhui province, Shandong, China E-mail :
Asian Pac J Cancer Prev. 2016;17(5):2711-7.
Through search the possible randomized control trials, we make a renewed meta-analysis in order to assess the impact of aspirin in preventing the recurrence of colorectal adenoma.
The Medicine/PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese biomedical literature service system (SinoMed) databases were searched for the related randomized controlled trials until to the April 2016. Three different authors respectively evaluated the quality of studies and extracted data, and we used the STATA software to analyze, investigate heterogeneity between the data, using the fixed-effects model to calculate and merge data.
7 papers were included the renewed meta- analysis, among these studies, two pairs were identified as representing the same study population, with the only difference being the duration of follow-up. Thus there were only five papers included our meta-analysis, and one Chinese paper were also included the work. Results were categorized by the length of follow-up, different kinds of people, varied dose of oral aspirin. The relative of adenoma in patients taking aspirin vs placebo were 0.73 (95% CI 0.55-0.98, P=0.039) with 1 year follow up; 0.84 (95% CI 0.72-0.98, P=0.484) with greater than 1 year follow up; for the advanced adenoma, the RR 0.68 (95% CI 0.49-0.94, P=0.582),for one year; RR=0.75 (95% CI 0.52-1.07, P=0.552) for greater one year. Furthermore the white population could divided into two subgroups according to the different length of follow-up time. When the length of follow-up time less than 3-year, The RR of two subgroups respective were RR=0.86 (95% CI 0.76-0.98, P=0.332), I2=0%, RR=0.68 (95% CI 0.47-0.98, P=0.552), I2=64.6%, But with the extension of follow-up time greater than 2-year, with the white, oral aspirin without considering dose had no efficacy on preventing the recurrence of any adenoma, the RR was 0.86 (95% CI 0.71-1.05, P=0.302), I2=16.4%.
This meta-analysis indicated that oral aspirin is associated with a remarkable decrease in the recurrence of any adenoma and advanced adenomas in patients follow-up for 1 year without concerning the dose of aspirin, but with the extension of follow-up time for greater than 1 year, oral aspirin can be effective on preventing the recurrence of any adenoma, but for the advanced adenoma, the result indicated that oral aspirin had no efficacy, According to the inclusion of ethnic groups, we also divided relevant papers into two subgroups as the yellow and white group. Then the follow-up time was less than 3 years, oral aspirin without considering the dose, had an significant efficacy on preventing the recurrence of any adenoma. But with the follow-up greater than 2 years, oral aspirin had no effect in the white.
通过检索可能的随机对照试验，我们进行了一项新的荟萃分析，以评估阿司匹林在预防结直肠腺瘤复发中的作用。
检索了医学/生物医学数据库、Embase、Cochrane对照试验中心注册库（CENTRAL）、中国生物医学文献服务系统（SinoMed）等数据库中截至2016年4月的相关随机对照试验。由三位不同的作者分别评估研究质量并提取数据，我们使用STATA软件进行分析，研究数据间的异质性，采用固定效应模型计算并合并数据。
7篇论文纳入了此次新的荟萃分析，在这些研究中，有两对被确定代表相同的研究人群，唯一的差异在于随访时间。因此，我们的荟萃分析仅纳入了5篇论文，其中还包括1篇中文论文。结果按随访时间长短、不同人群、口服阿司匹林剂量不同进行分类。服用阿司匹林与服用安慰剂的患者相比，随访1年时腺瘤复发的相对风险为0.73（95%可信区间0.55 - 0.98，P = 0.039）；随访时间大于1年时为0.84（95%可信区间0.72 - 0.98，P = 0.484）；对于高级别腺瘤，随访1年时相对风险（RR）为0.68（95%可信区间0.49 - 0.94，P = 0.582）；随访时间大于1年时RR = 0.75（95%可信区间0.52 - 1.07，P = 0.552）。此外，白人群体可根据随访时间长短分为两个亚组。当随访时间小于3年时，两个亚组的RR分别为RR = 0.86（95%可信区间0.76 - 0.98，P = 0.332），I² = 零，RR = 0.68（95%可信区间0.47 - 0.98，P = 0.552），I² = 64.6%。但随着随访时间延长至大于2年，对于白人群体，无论剂量如何，口服阿司匹林对预防任何腺瘤复发均无效果，RR为0.86（95%可信区间0.71 - 1.05，P = 0.302），I² = 16.4%。
这项荟萃分析表明，在随访1年的患者中，口服阿司匹林与任何腺瘤和高级别腺瘤复发的显著减少相关，且与阿司匹林剂量无关，但随着随访时间延长至大于1年，口服阿司匹林对预防任何腺瘤复发可能有效，但对于高级别腺瘤，结果表明口服阿司匹林无效。根据纳入的种族群体，我们还将相关论文分为黄种人和白种人两个亚组。当随访时间小于3年时，无论剂量如何，口服阿司匹林对预防任何腺瘤复发均有显著效果。但随访时间大于2年时，口服阿司匹林对白种人无效。
