荟萃分析揭示了急性胰腺炎与胰腺癌风险之间的关联。
Meta-analysis reveals an association between acute pancreatitis and the risk of pancreatic cancer.
作者信息
Liu Jie, Wang Ying, Yu Yue
机构信息
Department of Gastroenterology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui Province, China.
Endoscopy Center Department, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, Anhui Province, China.
出版信息
World J Clin Cases. 2020 Oct 6;8(19):4416-4430. doi: 10.12998/wjcc.v8.i19.4416.
BACKGROUND
Chronic pancreatitis is associated with pancreatic cancer (PC), although the relationship between acute pancreatitis (AP) and the risk of PC remains unclear due to inconsistent and contradictory results.
AIM
To conduct a meta-analysis of retrospective and prospective studies to explore the association between AP and PC risk.
METHODS
We first searched original articles on the association of AP with PC using PubMed, Web of Science, Cochrane, and EMBASE databases. Then we calculated the combined overall effect estimates (EEs) between AP and PC risk at a 95% confidence interval (CI) deploying a random-effects model, and assessed heterogeneity using the test. The combined relative risk with 95%CI was performed to examine the relationship between AP and PC. Publication bias and subgroup analyses were also conducted. Furthermore, we performed sensitivity analysis to explain this heterogeneity.
RESULTS
Eleven studies were eligible for inclusion standards in this meta-analysis, resulting in pooled EEs of 2.07 (95%CI: 1.36-2.78) for AP and PC risk. Additionally, five prospective cohort studies reported 103961 patients in the AP group, relative to 1442158 subjects in the control group, with a pooled relative risk of 7.81 (95%CI: 5.00-12.19). We also performed subgroup analyses using different follow-up times and type of research methods (case-control or cohort). Results from analyses of different follow-up times revealed the following pooled effect values: 1-year lag period (EEs = 23.47, 95%CI: 3.26-43.68), 2-year lag period (EEs = 9.82, 95%CI: 3.01-16.64), 5-year lag period (EEs = 2.47, 95%CI: 1.93-3.02), 10-year lag period (EEs = 1.69, 95%CI: 1.26-2.11), and > 10-year lag period (EEs = 1.17, 95%CI: 0.78-1.57). With regards to the methods, the case-control studies recorded EEs = 3.03 (95%CI: -1.02 to 7.08), whereas cohort studies had EEs = 2.09 (95%CI: 1.22-2.97) pooled effect values.
CONCLUSION
Overall, our findings indicated an association between AP and PC risk. Based on subgroup analyses, AP is unlikely to be a causal factor for PC.
背景
慢性胰腺炎与胰腺癌（PC）相关，尽管由于结果不一致且相互矛盾，急性胰腺炎（AP）与PC风险之间的关系仍不明确。
目的
对回顾性和前瞻性研究进行荟萃分析，以探讨AP与PC风险之间的关联。
方法
我们首先使用PubMed、Web of Science、Cochrane和EMBASE数据库搜索关于AP与PC关联的原始文章。然后，我们采用随机效应模型计算AP与PC风险之间在95%置信区间（CI）的合并总体效应估计值（EEs），并使用 检验评估异质性。进行95%CI的合并相对风险分析，以检验AP与PC之间的关系。还进行了发表偏倚和亚组分析。此外，我们进行了敏感性分析以解释这种异质性。
结果
11项研究符合本荟萃分析的纳入标准，得出AP与PC风险的合并EEs为2.07（95%CI：1.36 - 2.78）。此外，5项前瞻性队列研究报告了AP组中的103961名患者，对照组中有1442158名受试者，合并相对风险为7.81（95%CI：5.00 - 12.19）。我们还使用不同的随访时间和研究方法类型（病例对照或队列）进行了亚组分析。不同随访时间的分析结果显示了以下合并效应值：1年滞后期（EEs = 23.47，95%CI：3.26 - 43.68），2年滞后期（EEs = 9.82，95%CI：3.01 - 16.64），5年滞后期（EEs = 2.47，95%CI：1.93 - 3.02），10年滞后期（EEs = 1.69，95%CI：1.26 - 2.11），以及>10年滞后期（EEs = 1.17，95%CI：0.78 - 1.57）。关于方法，病例对照研究记录的EEs = 3.03（95%CI： - 1.02至7.08），而队列研究的合并效应值EEs = 2.09（95%CI：1.22 - 2.97）。
结论
总体而言，我们的研究结果表明AP与PC风险之间存在关联。基于亚组分析，AP不太可能是PC的因果因素。
Zotero 插件