Huang Yuenan, You Liuping, Xie Weimin, Ning Li, Lang Jinghe
Department of General Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Oncotarget. 2017 Aug 10;8(59):100570-100581. doi: 10.18632/oncotarget.20141. eCollection 2017 Nov 21.
Previous studies evaluating the association between smoking and risk of cholangiocarcinoma (CCA) have yielded controversial results. We conducted a meta-analysis to evaluate the association based on available evidence. We searched the databases of Embase, PubMed and Cochrane Central Register of Controlled Trials from inception to April 11, 2017. Studies that investigated the association between smoking and risk of CCA were included. Pooled odds ratio (OR) estimates and 95% confidence intervals (CIs) were calculated using either a random-effects or a fixed-effects model. A total of 22 studies involving 324,333 participants were identified. The summary OR of CCA was 1.31 (95% CI, 1.15 to 1.51) for smokers versus nonsmokers. The increased risk was independent of diabetes mellitus, bilious tract stone disease, and liver cirrhosis. Smokers also had increased risk of intrahepatic CCA (12 studies; OR, 1.31; 95% CI, 1.06 to 1.63) and extrahepatic CCA (12 studies; OR, 1.32; 95% CI, 1.10 to 1.59) compared with nonsmokers. The results of our meta-analysis support the hypothesis that there is a moderate association between cigarette smoking and risk of CCA.
以往评估吸烟与胆管癌（CCA）风险之间关联的研究结果存在争议。我们进行了一项荟萃分析，以根据现有证据评估这种关联。我们检索了Embase、PubMed和Cochrane对照试验中央注册库数据库，检索时间从数据库建立至2017年4月11日。纳入了调查吸烟与CCA风险之间关联的研究。使用随机效应模型或固定效应模型计算合并比值比（OR）估计值和95%置信区间（CI）。共确定了22项研究，涉及324,333名参与者。吸烟者与非吸烟者相比，CCA的汇总OR为1.31（95%CI，1.15至1.51）。风险增加与糖尿病、胆道结石病和肝硬化无关。与非吸烟者相比，吸烟者患肝内CCA（12项研究；OR，1.31；95%CI，1.06至1.63）和肝外CCA（12项研究；OR，1.32；95%CI，1.10至1.59）的风险也增加。我们的荟萃分析结果支持吸烟与CCA风险之间存在中度关联这一假设。
