Yang Zhen-Xiao, Yan Lu-Bin, Xie Peng, Hu Peng, Zhao Wenjing, Lu Yi, Xing Xiangbing, Liu Xudong
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
Front Oncol. 2022 Jun 30;12:928672. doi: 10.3389/fonc.2022.928672. eCollection 2022.
Serum pepsinogens are serological biomarkers of gastric atrophy, and the latter is a risk factor for esophageal squamous cell carcinoma (ESCC). However, the association of serum pepsinogens with ESCC risk remains unclear. This systematic review and meta-analysis aimed to assess the relationship between serum pepsinogen I (PGI) and pepsinogen I: pepsinogen II ratio (PGR) and ESCC risk.
PubMed, Embase, and Web of Science were searched for articles on the effect of serum PGI and PGR on ESCC risk, published up to the end of February 2022. Meta-analysis with a random-effect model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).
Five case-control studies and three prospective studies were included. In comparison with the high categories, the low categories of serum PGI (OR: 1.92, 95% CI: 1.45-2.56) and PGR (OR: 1.70, 95% CI: 1.01-2.85) were associated with an increased risk of ESCC, although a substantial heterogeneity was observed in serum PGR ( = 60.2%, = 0.028) rather than in serum PGI ( = 46.4%, = 0.070). In stratified analysis by study quality, the significant risk effect on ESCC was remained for PGI (OR: 2.05, 95% CI: 1.48-2.84) and PGR (OR: 2.07, 95% CI: 1.17-3.75) when only the studies with high quality were pooled.
Based on the available studies, although limited in number, this systematic review along with meta-analysis suggests that low serum PGI and low PGR may be related to an increased risk of ESCC. This present study provides evidence for using serum pepsinogen biomarkers in predicting ESCC. More delicate well-designed cohort studies with high study quality are needed, and dose-response analysis should be performed.
血清胃蛋白酶原是胃萎缩的血清学生物标志物，而胃萎缩是食管鳞状细胞癌（ESCC）的一个危险因素。然而，血清胃蛋白酶原与ESCC风险之间的关联仍不清楚。本系统评价和荟萃分析旨在评估血清胃蛋白酶原I（PGI）和胃蛋白酶原I与胃蛋白酶原II比值（PGR）与ESCC风险之间的关系。
检索PubMed、Embase和Web of Science数据库中截至2022年2月底发表的关于血清PGI和PGR对ESCC风险影响的文章。采用随机效应模型进行荟萃分析，计算合并比值比（OR）和95%置信区间（CI）。
纳入了5项病例对照研究和3项前瞻性研究。与高类别相比，低类别血清PGI（OR：1.92，95%CI：1.45-2.56）和PGR（OR：1.70，95%CI：1.01-2.85）与ESCC风险增加相关，尽管血清PGR存在较大异质性（I² = 60.2%，P = 0.028），而血清PGI的异质性为（I² = 46.4%，P = 0.070）。在按研究质量进行的分层分析中，仅汇总高质量研究时，PGI（OR：2.05，95%CI：1.48-2.84）和PGR（OR：2.07，95%CI：1.17-3.75）对ESCC仍有显著的风险效应。
基于现有研究，尽管数量有限，但本系统评价和荟萃分析表明，低血清PGI和低PGR可能与ESCC风险增加有关。本研究为使用血清胃蛋白酶原生物标志物预测ESCC提供了证据。需要更多设计精细、研究质量高的队列研究，并应进行剂量反应分析。
