Pu Yuting, Zhu Gangcai, Xu Yimin, Zheng Siyuan, Tang Bin, Huang Huimei, Wu Irene X Y, Huang Donghai, Liu Yong, Zhang Xin
Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.
Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.
Front Immunol. 2021 Feb 23;12:627226. doi: 10.3389/fimmu.2021.627226. eCollection 2021.
Vitamin D deficiency is a well-described preventable cause of many cancers; the association of vitamin D use with the development of head and neck cancer (HNC) is not clear. We aim to conduct a systematic review of the studies assessing the relation between vitamin D exposure and the prevention and prognosis of the HNC using meta-analysis.
PubMed, EMBASE, Cochrane Library, Web of Science up to 1 January 2021, and reference lists of related studies were searched. We extracted observational studies reporting the association between vitamin D (vitamin D receptor gene polymorphisms, 25-hydroxyvitamin D concentrations, and vitamin D intake) and the outcomes of interest (HNC incidence and HNC mortality) in HNC patients aged 18 or older. Fixed effects models were used to calculate pooled effect sizes and 95% confidence intervals (CIs) by RevMan (version 5.3).
Sixteen studies with a total of 81,908 participants were enrolled in our meta-analysis. Based on the pooled genomic analysis, comparing with participants with the genotypes of + or , the pooled odds ratio (OR) of participants with the genotype of was 0.77 (95% CI: 0.61 to 0.97) and 0.75 (0.58 to 0.97), respectively. A similar trend was noted when comparing with + or , in which OR (95% CI) was 0.70 (0.55 to 0.90) and 0.72 (0.55 to 0.95). No significant association was identified between polymorphism and HNC. Furthermore, the OR of HNC incidence was 0.77 (0.65 to 0.92) for participants with vitamin D intake over the ones with a regular diet. High concentrations of circulated 25-hydroxyvitamin D (25-OHD) significantly decreased by 32% of HNC incidence (OR (95% CI): 0.68 (0.59 to 0.78)) and increased HNC survival (pooled hazard ratio 1.13, 1.05 to 1.22) during a 4-5 years follow-up. High concentrations of circulating 25-OHD in patients with HNC led to a decreased risk of mortality to 0.75 (0.60 to 0.94) as the follow-up extends to 8-12 years.
Elevated activities of vitamin D by diet intake, genomic polymorphisms, or circulated 25-OHD may protect people from HNC and improve the prognosis of patients with HNC.
PROSPERO, identifier CRD42020176002 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=176002).
维生素D缺乏是多种癌症中一种已被充分描述的可预防病因；维生素D的使用与头颈癌（HNC）发生之间的关联尚不清楚。我们旨在通过荟萃分析对评估维生素D暴露与HNC预防及预后关系的研究进行系统评价。
检索截至2021年1月1日的PubMed、EMBASE、Cochrane图书馆、Web of Science以及相关研究的参考文献列表。我们提取了报告18岁及以上HNC患者中维生素D（维生素D受体基因多态性、25-羟基维生素D浓度和维生素D摄入量）与感兴趣结局（HNC发病率和HNC死亡率）之间关联的观察性研究。使用RevMan（5.3版）的固定效应模型计算合并效应量和95%置信区间（CI）。
16项研究共81908名参与者纳入我们的荟萃分析。基于汇总的基因组分析，与基因型为+或的参与者相比，基因型为的参与者的合并比值比（OR）分别为0.77（95%CI：0.61至0.97）和0.75（0.58至0.97）。与+或相比时也观察到类似趋势，其中OR（95%CI）为0.70（0.55至0.90）和0.72（0.55至0.95）。未发现多态性与HNC之间存在显著关联。此外，维生素D摄入量高的参与者与常规饮食者相比，HNC发病率的OR为0.77（0.65至0.92）。高浓度循环25-羟基维生素D（25-OHD）在4至5年随访期间使HNC发病率显著降低32%（OR（95%CI）：0.68（0.59至0.78））并提高了HNC生存率（合并风险比1.13，1.
