Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China.
Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Sleep Med. 2021 Aug;84:195-204. doi: 10.1016/j.sleep.2021.05.029. Epub 2021 Jun 21.
This paper assessed the connection between obstructive sleep apnea (OSA) and the incidence of malignant tumors.
PubMed, Cochrane, Scopus, Health Source Nursing Academic Edition, EMBASE, and Web of Sciences were searched until the date of July 25, 2020. The analysis included an assessment of the overall incidence of OSA malignancies, the incidence of OSA malignancies by age and gender, and the incidence of different types of malignancies in patients with OSA. The total rate and the corresponding 95% confidence interval (CI) of the incidence of malignant tumors in patients with OSA were calculated. Patients with OSA were classified according to age, gender, and different types of malignant tumors for meta-analysis.
A total of 12 studies involving 862,820 participants were included in this meta-analysis. Random effect model analysis showed that the total incidence of malignant tumors in patients with OSA was 0.046% (95% CI: 0.027-0.065, P < 0.001), higher than that of malignant tumors in the general population. According to the analytical results classified by gender, the incidence of malignant tumor in female patients with OSA was 4.0% (95% CI: 0.014-0.066), higher than that in male patients at 3.5% (95% CI: 0.012-0.058). The analytical results classified by age showed that the incidence of malignant tumors in patients with OSA aged below 60 years was 1.8% (95% CI: 0.000-0.036), lower than that in patients aged above 60 years at 4.3% (95% CI: 0.002-0.084). The analytical results classified by the types of malignant tumors showed that the incidences of breast cancer, lung cancer, colorectal cancer, prostate cancer, kidney cancer, pancreatic cancer, and melanoma in patients with OSA were 0.5% (95% CI: 0.001-0.008), 0.5% (95% CI: 0.002-0.009), 0.5% (95% CI: 0.003-0.008), 1.1% (95% CI: 0.002-0.021), 0.3% (95% CI: 0.001-0.005), 0.1% (95% CI: 0.001-0.002), and 0.4% (95% CI: 0.003-0.005), respectively. Among them, the incidence of prostate cancer was the highest, followed by breast cancer, lung cancer, colorectal cancer, melanoma, and kidney cancer, whereas the incidence of pancreatic cancer was the lowest. However, the incidence of specific malignant tumors in patients with OSA did not have a significant increase compared with that in the general population.
The analytical results of this meta-analysis suggested that OSA may be associated with an overall increase in the incidence of malignancies based on the currently available data, but the connection with specific types of malignancies was not significant. Further studies are needed to explore this association in the future.
本文评估阻塞性睡眠呼吸暂停（OSA）与恶性肿瘤发病率之间的关系。
检索 PubMed、Cochrane、Scopus、Health Source Nursing Academic Edition、EMBASE 和 Web of Sciences 数据库，检索日期截至 2020 年 7 月 25 日。分析包括评估 OSA 恶性肿瘤的总体发病率、按年龄和性别划分的 OSA 恶性肿瘤发病率，以及 OSA 患者不同类型恶性肿瘤的发病率。计算 OSA 患者恶性肿瘤总发病率和相应的 95%置信区间（CI）。根据年龄、性别和不同类型的恶性肿瘤对 OSA 患者进行分类，进行荟萃分析。
本荟萃分析共纳入 12 项研究，涉及 862820 名参与者。随机效应模型分析显示，OSA 患者恶性肿瘤总发病率为 0.046%（95%CI：0.027-0.065，P<0.001），高于普通人群的恶性肿瘤发病率。按性别进行分析的结果显示，女性 OSA 患者恶性肿瘤发病率为 4.0%（95%CI：0.014-0.066），高于男性患者的 3.5%（95%CI：0.012-0.058）。按年龄进行分析的结果显示，60 岁以下 OSA 患者恶性肿瘤发病率为 1.8%（95%CI：0.000-0.036），低于 60 岁以上患者的 4.3%（95%CI：0.002-0.084）。按恶性肿瘤类型进行分析的结果显示，OSA 患者乳腺癌、肺癌、结直肠癌、前列腺癌、肾癌、胰腺癌和黑色素瘤的发病率分别为 0.5%（95%CI：0.001-0.008）、0.5%（95%CI：0.002-0.009）、0.5%（95%CI：0.003-0.008）、1.1%（95%CI：0.002-0.021）、0.3%（95%CI：0.001-0.005）、0.1%（95%CI：0.001-0.002）和 0.4%（95%CI：0.003-0.005）。其中，前列腺癌发病率最高，其次是乳腺癌、肺癌、结直肠癌、黑色素瘤和肾癌，而胰腺癌的发病率最低。然而，OSA 患者特定恶性肿瘤的发病率与普通人群相比并没有显著增加。
本荟萃分析的结果提示，根据目前的数据，OSA 可能与恶性肿瘤总体发病率的增加有关，但与特定类型恶性肿瘤的相关性不显著。未来需要进一步研究来探讨这种关联。
