柑橘类水果摄入量与食管癌风险:一项荟萃分析。
Intakes of citrus fruit and risk of esophageal cancer: A meta-analysis.
作者信息
Zhao Wenyue, Liu Lu, Xu Shun
机构信息
Department of Thoracic Surgery of the First Affiliated Hospital Department of Breast Surgery of the First Affiliated Hospital, China Medical University, Shenyang, China.
出版信息
Medicine (Baltimore). 2018 Mar;97(13):e0018. doi: 10.1097/MD.0000000000010018.
Esophageal cancer (EC) is the eighth most common cancer and the sixth most frequent cause of cancer death in the whole world. Many studies have investigated the association between citrus fruit intake and the risk of EC, but the results are inconsistent and not analyzed by category. We aimed to perform a meta-analysis of studies to evaluate the incidence between citrus fruit consumption and subtypes of esophageal cancer and derive a more precise estimation.Through searches of PubMed, OVID, and Web of Science we updated 1988 systematic review up to April 2016. Based on an inclusion and exclusion criteria, conventional meta-analysis according to DerSimonian and Laird method was used for the pooling of the results. Random-effect models were used to calculate subgroups.Twenty-five English articles (20 case-control studies and 5 cohort studies) comprising totally 5730 patients of esophageal cancer would be suitable for use in this study. The result indicated the inverse associations between intakes of citrus fruit and EC (relative risk [RR] = 0.65, 95% confidence interval [CI] 0.56-0.75, I = 51.1%, P = .001), Esophageal squamous cell carcinoma (ESCC) (RR = 0.59, 95% CI 0.47-0.76, I = 60.7%, P = .002), no significant relationship between citrus fruit and esophageal adenocarcinoma (EAC) (RR = 0.86, 95% CI 0.74-1.01, I = 0.0%, P = .598).This meta-analysis indicates that intakes of citrus fruit significantly reduce the risk of ESCC and is no obvious relationship with EAC. Further studies about constituents in citrus fruit and its mechanism are warranted.
食管癌(EC)是全球第八大常见癌症,也是第六大癌症死亡原因。许多研究探讨了柑橘类水果摄入量与食管癌风险之间的关联,但结果并不一致,且未按类别进行分析。我们旨在对相关研究进行荟萃分析,以评估柑橘类水果消费与食管癌亚型之间的发病率,并得出更精确的估计。通过检索PubMed、OVID和科学网,我们更新了截至2016年4月的1988年系统评价。根据纳入和排除标准,采用DerSimonian和Laird方法进行传统荟萃分析以汇总结果。使用随机效应模型计算亚组。25篇英文文章(20项病例对照研究和5项队列研究),共纳入5730例食管癌患者,适合本研究使用。结果表明,柑橘类水果摄入量与食管癌(相对风险[RR]=0.65,95%置信区间[CI]0.56-0.75,I=51.1%,P=0.001)、食管鳞状细胞癌(ESCC)(RR=0.59,95%CI 0.47-0.76,I=60.7%,P=0.002)呈负相关,柑橘类水果与食管腺癌(EAC)之间无显著关系(RR=0.86,95%CI 0.74-1.01,I=0.0%,P=0.598)。这项荟萃分析表明,柑橘类水果摄入量可显著降低ESCC的风险,与EAC无明显关系。有必要对柑橘类水果的成分及其作用机制进行进一步研究。