Peng Tzu-Rong, Wu Ta-Wei, Li Chung-Hsien
Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Division of Gastroenterology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, #289, Jianguo Road, Xindian Dist., New Taipei City, 23142, Taiwan, Republic of China.
Int J Clin Oncol. 2023 Jan;28(1):99-109. doi: 10.1007/s10147-022-02253-2. Epub 2022 Oct 12.
Proton pump inhibitors (PPIs) may be associated with gastric cancer, but studies in recent years have proven still inconsistent results. We conducted a systematic review and meta-analysis to investigate the association between PPI use and gastric cancer.
Pubmed, EMBASE, and Cochrane library were searched for studies published up to 15th February 2022. Studies on the association between PPI and the risk of gastric cancer, pooled the odds ratios (ORs) using a random-effects model. The subgroup analysis for study design, site of gastric cancer, and the duration of PPI use was performed. Heterogeneity was assessed using the I and Cochran's Q statistics.
Sixteen cohorts and case-control studies were included. PPI use was significantly associated with gastric cancer (OR: 1.75, 95% CI: 1.28-2.40). The subgroup analysis found a significant risk increase in non-cardia gastric cancer (OR: 2.14, 95%CI: 1.50-3.07). There was no duration-dependent effect of PPI use and gastric cancer risk (< 1 year: OR: 2.56, 95% CI: 1.41-4.64, I = 98%; 1-3 years: OR: 1.47, 95% CI: 1.26-1.71, I = 41%; > 3 years: OR: 1.58, 95% CI: 1.16-2.14, I = 74%).
PPIs were significantly associated with an increased risk of gastric cancer. However, this association does not confirm causation. Several well-design studies are needed to confirm the findings in the future.
质子泵抑制剂（PPIs）可能与胃癌有关，但近年来的研究结果仍不一致。我们进行了一项系统评价和荟萃分析，以研究使用PPIs与胃癌之间的关联。
检索了截至2022年2月15日发表的PubMed、EMBASE和Cochrane图书馆的研究。关于PPIs与胃癌风险之间关联的研究，使用随机效应模型汇总比值比（OR）。对研究设计、胃癌部位和PPIs使用持续时间进行亚组分析。使用I²和Cochran's Q统计量评估异质性。
纳入了16项队列研究和病例对照研究。使用PPIs与胃癌显著相关（OR：1.75，95%CI：1.28 - 2.40）。亚组分析发现非贲门胃癌的风险显著增加（OR：2.14，95%CI：1.50 - 3.07）。PPIs使用持续时间与胃癌风险之间没有剂量依赖效应（<1年：OR：2.56，95%CI：1.41 - 4.64，I² = 98%；1 - 3年：OR：1.47，95%CI：1.26 - 1.71，I² = 41%；>3年：OR：1.58，95%CI：1.16 - 2.14，I² = 74%）。
PPIs与胃癌风险增加显著相关。然而，这种关联并不能证实因果关系。未来需要几项设计良好的研究来证实这些发现。
