Ma Shaoze, Guo Xiaozhong, Wang Chunmei, Yin Yue, Xu Guangqin, Chen Hongxin, Qi Xingshun
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China; Graduate School, Jinzhou Medical University, Jinzhou, China.
Ther Adv Chronic Dis. 2022 Aug 22;13:20406223221117971. doi: 10.1177/20406223221117971. eCollection 2022.
Barrett's esophagus (BE) is the only recognized precursor for esophageal adenocarcinoma. () infection is a major contributing factor towards upper gastrointestinal diseases, but its relationship with BE remains controversial. Some previous studies suggested that infection negatively correlated with BE, while others did not. This may be attributed to the difference in the selection of control groups among studies. The present meta-analysis aims to clarify their association by combining all available data from well-designed studies.
The , , and databases were searched. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by a random-effects model. Heterogeneity was evaluated using the Cochran's Q test and statistics. Meta-regression, subgroup, and leave-one-out sensitivity analyses were employed to explore the sources of heterogeneity.
Twenty-four studies with 1,354,369 participants were included. Meta-analysis found that patients with BE had a significantly lower prevalence of infection than those without (OR = 0.53, 95% CI = 0.45-0.64; < 0.001). The heterogeneity was statistically significant (² = 79%; < 0.001). Meta-regression, subgroup, and leave-one-out sensitivity analyses did not find any source of heterogeneity. Meta-analysis of 7 studies demonstrated that CagA-positive infection inversely correlated with BE (OR = 0.25, 95% CI = 0.15-0.44; = 0.000), but not CagA-negative infection (OR = 1.22, 95% CI = 0.90-1.67; = 0.206). Meta-analysis of 4 studies also demonstrated that infection inversely correlated with LSBE (OR = 0.39, 95% CI = 0.18-0.86; = 0.019), but not SSBE (OR = 0.73, 95% CI = 0.30-1.77; = 0.484).
infection negatively correlates with BE. More experimental studies should be necessary to elucidate the potential mechanisms in future.
巴雷特食管（BE）是目前唯一公认的食管腺癌癌前病变。（）感染是上消化道疾病的主要促成因素，但其与BE的关系仍存在争议。既往一些研究表明，（）感染与BE呈负相关，而另一些研究则未发现此关联。这可能归因于各研究中对照组选择的差异。本荟萃分析旨在通过合并精心设计研究中的所有可用数据来阐明它们之间的关联。
检索了（）、（）和（）数据库。采用随机效应模型汇总比值比（OR）及其95%置信区间（CI）。使用 Cochr an's Q检验和（）统计量评估异质性。采用荟萃回归、亚组分析和逐一剔除敏感性分析来探索异质性来源。
纳入了24项研究，共1354369名参与者。荟萃分析发现，BE患者的（）感染患病率显著低于非BE患者（OR = 0.53，95%CI = 0.45 - 0.64；（）< 0.001）。异质性具有统计学意义（（）² = 79%；（）< 0.001）。荟萃回归、亚组分析和逐一剔除敏感性分析均未发现异质性来源。对7项研究的荟萃分析表明，CagA阳性（）感染与BE呈负相关（OR = 0.25，95%CI = 0.15 - 0.44；（）= 0.000），而CagA阴性（）感染则不然（OR = 1.22，95%CI = 0.90 - 1.67；（）= 0.206）。对4项研究的荟萃分析还表明，（）感染与长节段BE（LSBE）呈负相关（OR = 0.39，95%CI = 0.18 - 0.86；（）= 0.019），但与短节段BE（SSBE）无关（OR = 0.73，95%CI = 0.30 - 1.77；（）= 0.484）。
（）感染与BE呈负相关。未来需要更多的实验研究来阐明其潜在机制。
需注意，原文中部分括号内容缺失，翻译时保留了括号形式。
