Xu Wei, Zhou Xiaochong, Yin Minyue, Gao Jingwen, Weng Zhen, Xu Chunfang
Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Cyrus Tang Hematology Center and Ministry of Education Engineering Center of Hematological Disease, and the Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
Transl Cancer Res. 2022 Aug;11(8):2810-2822. doi: 10.21037/tcr-21-2803.
The relationship between (, HP) infection and pancreatic cancer would be investigated in this article.
All cohort studies and case-control studies about infection and pancreatic cancer up to October 2021 were searched in the databases of PubMed, Embase and Cochrane. The combined odds ratio (OR) and 95% confidence interval (CI) were calculated by R 4.1.0 software. Funnel plot and Egger test were used to evaluate publication bias.
A total of 17 studies which included 8 case-control studies, 5 nested case-control studies, and 4 cohort studies were included in this study, and the results of this article have confirmed that the infection was significantly correlated with the occurrence of pancreatic cancer (OR =1.30, 95% CI: 1.02-1.64), especially in economically underdeveloped areas (OR =2.10, 95% CI: 1.44-3.05). However, negative results were obtained in the relationship between CagA + and pancreatic cancer. Similarly, we also did not find an association between vacuolating cytotoxin gene A-positive strains (VacA-positive ) and pancreatic cancer. The heterogeneity of this study was significant. Through a sensitivity analysis by the leave-one-out method, we found the results remained unchanged on the whole but the correlation between infection and the occurrence of pancreatic cancer in the Asian population was significant. The tests for funnel plot asymmetry indicated that there might be obvious publication bias in this study. After carrying out the Egger test, we proved the existence of the publication bias in this study, which could have a certain impact on the results.
Based on the currently available data, we confirm that infection can increase the incidence of pancreatic cancer in general. CagA/VacA-positive infection is not associated with the incidence of pancreatic cancer. infection is significantly associated with the incidence of pancreatic cancer in economically underdeveloped areas, while the relationship between infection and the incidence of pancreatic cancer in the Asian population is uncertain. In addition, more high-quality studies are needed to be included to confirm this conclusion.
本文将研究幽门螺杆菌（, HP）感染与胰腺癌之间的关系。
检索了截至2021年10月在PubMed、Embase和Cochrane数据库中所有关于幽门螺杆菌感染与胰腺癌的队列研究和病例对照研究。采用R 4.1.0软件计算合并比值比（OR）和95%置信区间（CI）。采用漏斗图和Egger检验评估发表偏倚。
本研究共纳入17项研究，其中包括8项病例对照研究、5项巢式病例对照研究和4项队列研究，本文结果证实幽门螺杆菌感染与胰腺癌的发生显著相关（OR =1.30，95% CI：1.02 - 1.64），尤其在经济欠发达地区（OR =2.10，95% CI：1.44 - 3.05）。然而，细胞毒素相关基因A阳性（CagA + ）幽门螺杆菌与胰腺癌之间的关系得到阴性结果。同样，我们也未发现空泡毒素基因A阳性菌株（VacA阳性幽门螺杆菌）与胰腺癌之间存在关联。本研究的异质性显著。通过逐一剔除法进行敏感性分析，我们发现总体结果保持不变，但亚洲人群中幽门螺杆菌感染与胰腺癌发生之间的相关性显著。漏斗图不对称性检验表明本研究可能存在明显的发表偏倚。进行Egger检验后，我们证实了本研究中发表偏倚的存在，这可能对结果产生一定影响。
基于目前可得的数据，我们证实幽门螺杆菌感染总体上可增加胰腺癌的发病率。CagA/VacA阳性幽门螺杆菌感染与胰腺癌的发病率无关。幽门螺杆菌感染在经济欠发达地区与胰腺癌的发病率显著相关，而亚洲人群中幽门螺杆菌感染与胰腺癌发病率之间的关系尚不确定。此外，需要纳入更多高质量研究来证实这一结论。
