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蒽醌类泻药的使用与结直肠癌：观察性研究的系统评价和荟萃分析。

Anthraquinone laxatives use and colorectal cancer: A systematic review and meta-analysis of observational studies.

机构信息

Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence; Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, Florence, Italy.

Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.

出版信息

Phytother Res. 2022 Mar;36(3):1093-1102. doi: 10.1002/ptr.7373. Epub 2022 Jan 17.

DOI:10.1002/ptr.7373
PMID:35040201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9305424/
Abstract

This systematic review and meta-analysis were conducted to determine the effects of anthraquinone (AQ) laxatives on colorectal cancer (CRC). We searched PubMed, Embase, Google Scholar, and CENTRAL from inception until March 2021, for randomized controlled trials (RCTs) and observational studies. Through the systematic review, we identified 8 observational studies evaluating AQ laxatives use as a risk factor for CRC development, and 5 studies on CRC risk were included in the meta-analysis using a random-effects model. Through the meta-analysis, we found that a history of AQ laxatives use compared with "other" and "no laxatives" use was associated with CRC development (OR: 1.41; 95% CI: 0.94-2.11), although not at a statistically significant level. The possible association persists even after removal of the outlier studies (OR: 1.51; 95% CI: 0.97-2.34). Selection of cases and controls was judged at low or unclear risk of bias across almost all studies, and the quality of evidence was from moderate to low. In conclusion, it is not possible to associate the use of AQ laxatives with the development of CRC. However, the trend toward an increased risk of CRC provides a strong indication for investigating this issue by performing further high-quality studies.

摘要

本系统评价和荟萃分析旨在确定蒽醌（AQ）类泻药对结直肠癌（CRC）的影响。我们从建库起至 2021 年 3 月，在 PubMed、Embase、Google Scholar 和 CENTRAL 中搜索了随机对照试验（RCT）和观察性研究，以评估 AQ 类泻药的使用作为 CRC 发展的危险因素。通过系统评价，我们确定了 8 项评估 AQ 类泻药使用作为 CRC 发展风险因素的观察性研究，其中 5 项研究纳入了荟萃分析，使用随机效应模型评估 CRC 风险。通过荟萃分析，我们发现与“其他”和“无泻药”相比，AQ 类泻药的使用史与 CRC 发展相关（OR：1.41；95%CI：0.94-2.11），尽管这一结果没有达到统计学显著水平。即使排除了异常值研究（OR：1.51；95%CI：0.97-2.34），这种关联仍然存在。几乎所有研究均认为病例和对照的选择存在低或不确定的偏倚风险，证据质量从中等到低。总之，目前尚不能将 AQ 类泻药的使用与 CRC 的发生联系起来。但是，CRC 发病风险增加的趋势强烈提示需要通过开展进一步的高质量研究来调查这一问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/d49104b8d12a/PTR-36-1093-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/e321b62331da/PTR-36-1093-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/142854cfd4d2/PTR-36-1093-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/362151e57839/PTR-36-1093-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/d0a297d3a277/PTR-36-1093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/eb0fb7611258/PTR-36-1093-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/e321b62331da/PTR-36-1093-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/142854cfd4d2/PTR-36-1093-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/362151e57839/PTR-36-1093-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9110/9305424/d0a297d3a277/PTR-36-1093-g002.jpg
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