Li Hong-Xing, Peng Xiao-Xiao, Zong Qiang, Zhang Kai, Wang Ming-Xin, Liu Yi-Zhe, Han Guang-Liang
Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China.
Department of Neurosurgery, Shengli Oilfield Central Hospital, Dongying, Shandong, People's Republic of China; Department of Intensive Care Unit, Dongying, Shandong, People's Republic of China.
Onco Targets Ther. 2016 Jun 14;9:3511-23. doi: 10.2147/OTT.S99713. eCollection 2016.
Cigarette smoking has been shown to be a risk factor for adult glioma by some but not all studies. We conducted a meta-analysis to systematically assess the potential association.
PubMed and EMBASE were searched from the date of their inception to October 1, 2015, to identify relevant articles. Reference lists from these articles were reviewed to identify additional studies. Both cohort and case-control studies were included. Fixed-effects models were used to calculate the overall relative risk (RR) with corresponding 95% confidence intervals (CIs).
The final analysis included 24 studies (seven cohort and 17 case-control studies), involving more than 2.3 million individuals. The combined RR was 1.04 (95% CI: 1.00, 1.09; P=0.073) for ever-smokers, 0.97 (95% CI: 0.88, 1.07; P=0.574) for current-smokers, and 1.07 (95% CI: 0.98, 1.16; P=0.130) for past smokers, with little evidence of heterogeneity. Omission of any single study from the analysis had little effect on the result. No evidence of publication bias was found. A small but statistically significant increase was found in past smokers in females (RR: 1.13, 95% CI: 1.00, 1.28; P=0.046) but not in males.
In general, there was no association between cigarette smoking and adult glioma. The small but statistically significant association in females requires further investigation.
一些研究表明吸烟是成人胶质瘤的一个风险因素，但并非所有研究都如此。我们进行了一项荟萃分析，以系统评估潜在的关联。
检索了从PubMed和EMBASE创建之日至2015年10月1日的相关文章。对这些文章的参考文献列表进行了审查，以识别其他研究。队列研究和病例对照研究均被纳入。使用固定效应模型计算总体相对风险（RR）及相应的95%置信区间（CI）。
最终分析纳入了24项研究（7项队列研究和17项病例对照研究），涉及超过230万人。曾经吸烟者的合并RR为1.04（95%CI：1.00，1.09；P=0.073），当前吸烟者为0.97（95%CI：0.88，1.07；P=0.574），既往吸烟者为1.07（95%CI：0.98，1.16；P=0.130），几乎没有异质性证据。分析中省略任何一项研究对结果影响不大。未发现发表偏倚的证据。在女性既往吸烟者中发现有小幅但具有统计学意义的增加（RR：1.13，95%CI：1.00，1.28；P=0.046），但男性中未发现。
总体而言，吸烟与成人胶质瘤之间没有关联。女性中这种小幅但具有统计学意义的关联需要进一步研究。
