Zhou Wence, Chen Xinlong, Fan Qigang, Yu Haichuan, Jiang Wenkai
First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, Gansu, China.
Front Pharmacol. 2022 Sep 14;13:979215. doi: 10.3389/fphar.2022.979215. eCollection 2022.
More and more studies are focusing on the adverse effects and damage caused by PPI abuse, we carried out a systematic review and meta-analysis for assessing whether the proton pump inhibitor (PPI) leads to hepato-biliary-pancreatic cancer. PubMed, EMBASE and Web of Science were searched until 1 July 2022, 25 studies (17 case-control and 8 cohort studies; 2741853 individuals) included in this study. Pooled Odd Ratios (ORs) were used for random effect models. Sensitivity analysis and dose-response analysis, subgroup analysis were all conducted. The aggregate OR of the meta-analysis was 1.69 (95% confidence interval (CI): 1.42-2.01, = 0.01) and heterogeneity ( = 98.9%, < 0.001) was substantial. According to stratified subgroup analyses, the incidence of hepato-biliary-pancreatic cancer was associated, expect for study design, study quality and region. Risk of hepato-biliary-pancreatic cancer is highest when people is treated with normal doses of PPI. The risks decrease and become insignificant when the cumulative defined daily dose (cDDD) increases. The use of PPI may be associated with an increased risk of hepato-biliary-pancreatic cancer. Hence, caution is needed when using PPIs among patients with a high risk of hepato-biliary-pancreatic cancer.
越来越多的研究聚焦于质子泵抑制剂（PPI）滥用所造成的不良反应和损害，我们进行了一项系统综述和荟萃分析，以评估质子泵抑制剂是否会导致肝胆胰癌症。检索了PubMed、EMBASE和Web of Science截至2022年7月1日的文献，本研究纳入了25项研究（17项病例对照研究和8项队列研究；共2741853名个体）。采用合并比值比（OR）用于随机效应模型。进行了敏感性分析、剂量反应分析和亚组分析。荟萃分析的总体OR为1.69（95%置信区间（CI）：1.42 - 2.01，P = 0.01），异质性较大（I² = 98.9%，P < 0.001）。根据分层亚组分析，除研究设计、研究质量和地区外，肝胆胰癌症的发病率存在关联。当人们使用正常剂量的PPI治疗时，患肝胆胰癌症的风险最高。当累积限定日剂量（cDDD）增加时，风险降低且变得不显著。使用PPI可能与肝胆胰癌症风险增加有关。因此，在肝胆胰癌症高危患者中使用PPI时需要谨慎。
