Fagundes Marcela de Araújo, Silva Alex Richard Costa, Fernandes Gisele Aparecida, Curado Maria Paula
Graduate Program of A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211, São Paulo 01509-900 , Brazil.
Group of Epidemiology and Statistics on Cancer, International Research Center, A.C. Camargo Cancer Center, R. Tagua 440, Sao Paulo 01508-010, Brazil.
Cancers (Basel). 2022 Nov 29;14(23):5878. doi: 10.3390/cancers14235878.
Phenolic compound consumption may have a protective effect against gastric cancer (GC). Most GC studies focus on the flavonoids class, but results are conflicting and knowledge gaps remain for other classes and total polyphenol intake. This study aimed to assess the association between polyphenol intake (total, flavonoids, and other classes) and GC.
In this systematic review and meta-analysis, the PubMed, Embase, Scopus, LILACS, Web of Science, and OpenGrey databases were searched for studies published up to 20 March 2022. Case-control and cohort studies analyzing the association between polyphenol intake and GC were included. For the meta-analysis, pooled summary estimates were calculated using a random-effects model, and the estimates extracted adjusted for most variables. Subgroup analyses were performed for subclass (e.g., flavonoids and other classes), sex, geographical area, study design, anatomical subtype, histological subtype, family history of GC and fruit and/or vegetable intake. The study was registered with PROSPERO (#CRD42022306014).
The search identified 2752 records, of which 19 studies published during the period 1999-2021 including a total of 1,197,857 subjects were eligible. Polyphenol consumption reduced GC risk by 29% (RR = 0.71; 95% CI: 0.62-0.81; I = 60.5%); while flavonoid intake decreased GC risk by 28% (RR = 0.72; 95% CI: 0.61-0.85; I = 64.3%), similar to the reduction fort other classes (RR = 0.65; 95% CI: 0.54-0.79; I = 72.0%). Protective effects against GC were observed in both sexes (male, RR = 0.79; 95% CI: 0.67-0.94, I = 31.6%; female, RR = 0.65; 95% CI: 0.48-0.87, I = 49.7%) and for intestinal subtype (RR = 0.65; 95% CI: 0.52-0.82, I = 0.0%). By continent, polyphenol consumption reduced GC risk in both Europe (RR = 0.67; 95% CI: 0.57-0.79, I = 44.2%) and Asia (RR = 0.67; 95% CI: 0.51-0.89, I = 60.7%).
Dietary polyphenol intake decreased GC risk. The reduction was greatest in females. Most previous studies were carried out in Europe and Asia. Further studies investigating polyphenol consumption and GC in Latin American populations are warranted.
食用酚类化合物可能对胃癌（GC）具有保护作用。大多数关于胃癌的研究集中在黄酮类化合物上，但结果相互矛盾，对于其他类别和总多酚摄入量仍存在知识空白。本研究旨在评估多酚摄入量（总多酚、黄酮类化合物和其他类别）与胃癌之间的关联。
在这项系统评价和荟萃分析中，检索了截至2022年3月20日在PubMed、Embase、Scopus、LILACS、Web of Science和OpenGrey数据库中发表的研究。纳入分析多酚摄入量与胃癌之间关联的病例对照研究和队列研究。对于荟萃分析，使用随机效应模型计算汇总估计值，并提取针对大多数变量进行调整后的估计值。对亚类（如黄酮类化合物和其他类别）、性别、地理区域、研究设计、解剖学亚型、组织学亚型、胃癌家族史以及水果和/或蔬菜摄入量进行亚组分析。该研究已在PROSPERO注册（#CRD42022306014）。
检索到2752条记录，其中19项在1999年至2021年期间发表的研究符合条件，共纳入1,197,857名受试者。食用多酚可使胃癌风险降低29%（风险比[RR]=0.71；95%置信区间[CI]：0.62 - 0.81；I²=60.5%）；而黄酮类化合物摄入量可使胃癌风险降低28%（RR = 0.72；95% CI：0.61 - 0.85；I²=64.3%），与其他类别降低的幅度相似（RR = 0.65；95% CI：0.54 - 0.79；I²=72.0%）。在男性（RR = 0.79；95% CI：0.67 - 0.94，I²=31.6%）和女性（RR = 0.65；95% CI：0.48 - 0.87，I²=49.7%）中均观察到对胃癌的保护作用，在肠型亚型中也有保护作用（RR = 0.65；95% CI：0.52 - 0.82，I²=0.0%）。按大洲划分，食用多酚在欧洲（RR = 0.67；95% CI：0.57 - 0.79，I²=44.2%）和亚洲（RR = 0.67；95% CI：0.51 - 0.89，I²=60.7%）均可降低胃癌风险。
饮食中多酚摄入量可降低胃癌风险。女性降低幅度最大。此前大多数研究在欧洲和亚洲进行。有必要进一步开展针对拉丁美洲人群多酚消费与胃癌关系的研究。
