Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Department of Internal Medicine, University of Hawaii, Honolulu, USA.
Dig Endosc. 2017 Jan;29(1):73-82. doi: 10.1111/den.12701. Epub 2016 Sep 15.
Diverticular disease and colorectal neoplasia are common digestive disorders worldwide. Both diseases share epidemiological trends and certain risk factors including advancing age, physical inactivity, and Western diet and lifestyle. Studies assessing the association between these diseases reported inconsistent results. Thus, we conducted a systematic review and meta-analysis to determine the association between diverticular disease and colorectal adenomas, advanced adenomas and cancer.
A comprehensive search of the databases MEDLINE and EMBASE was done from inception through March 2016. Inclusion criterion was the observational studies' assessment of the association between diverticular disease and colorectal neoplasia in adult participants. Pooled OR and 95% confidence interval (CI) were calculated using a random effect.
Data were extracted from 14 observational studies (11 cross-sectional studies, one case-control study and two cohort studies). Diverticular disease was associated with increased odds of adenomas (OR = 1.67, 95% CI 1.27-2.21, 10 studies), but not associated with advanced adenomas (OR = 1.19, 95% CI 0.88-1.62, I = 52%, four studies) or colorectal cancer (OR = 1.36, 95% CI 0.47-3.92, I = 98%, seven studies).
Our meta-analysis demonstrated that diverticular disease was associated with colorectal adenomas. Colonoscopists should be aware of this association and carefully examine the entire large bowel in individuals with diverticulosis.
憩室病和结直肠肿瘤是全球常见的消化系统疾病。这两种疾病具有共同的流行病学趋势和某些风险因素，包括年龄增长、缺乏身体活动、西方饮食和生活方式。评估这两种疾病之间相关性的研究结果不一致。因此，我们进行了一项系统评价和荟萃分析，以确定憩室病与结直肠腺瘤、高级别腺瘤和癌症之间的关系。
从创建数据库到 2016 年 3 月，我们对 MEDLINE 和 EMBASE 数据库进行了全面检索。纳入标准为评估成年参与者憩室病与结直肠肿瘤之间相关性的观察性研究。使用随机效应模型计算汇总比值比（OR）和 95%置信区间（CI）。
我们从 14 项观察性研究中提取数据（11 项横断面研究、1 项病例对照研究和 2 项队列研究）。憩室病与腺瘤的发生风险增加相关（OR=1.67，95%CI 1.27-2.21，10 项研究），但与高级别腺瘤（OR=1.19，95%CI 0.88-1.62，I²=52%，4 项研究）或结直肠癌（OR=1.36，95%CI 0.47-3.92，I²=98%，7 项研究）无关。
我们的荟萃分析表明，憩室病与结直肠腺瘤相关。结肠镜医师应该意识到这种相关性，并在憩室病患者中仔细检查整个大肠。
