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减重手术对胰腺癌风险的影响:系统评价和荟萃分析。

The Impact of Bariatric Surgery on Pancreatic Cancer Risk: a Systematic Review and Meta-Analysis.

机构信息

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.

Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.

出版信息

Obes Surg. 2023 Jun;33(6):1889-1899. doi: 10.1007/s11695-023-06570-x. Epub 2023 Apr 5.

Abstract

A growing body of evidence suggests that bariatric surgery is associated with a reduced risk of some cancers. This meta-analysis aims to determine whether bariatric surgery affects pancreatic cancer risk. We conducted a comprehensive literature search of PubMed, Embase, and Web of Science databases. Fixed-effect models were used to estimate pooled data and presented as odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was assessed using the Cochran Q test and I test. A total of 9 cohort studies involving 1,147,473 patients were included in the analysis. The pooled OR was 0.76 (95% CI = 0.64-0.90). The Cochran Q test and I test indicated only mild heterogeneity (P = 0.12, I = 38%). In the subgroup analyses, the pooled OR was 0.67 (95% CI = 0.54-0.82) for North America. In the subgroup analyses by mean follow-up time, the pooled OR was 0.46 (95% CI = 0.28-0.74) for less than 5 years. In conclusion, bariatric surgery has a positive effect on pancreatic cancer reduction, especially in North America. This effect may diminish or disappear with time.

摘要

越来越多的证据表明,减重手术与某些癌症风险降低有关。本荟萃分析旨在确定减重手术是否会影响胰腺癌风险。我们对 PubMed、Embase 和 Web of Science 数据库进行了全面的文献检索。使用固定效应模型来估计汇总数据,并以比值比(OR)和 95%置信区间(CI)表示。使用 Cochran Q 检验和 I 检验评估异质性。共有 9 项队列研究纳入了 1147473 名患者。汇总的 OR 为 0.76(95%CI=0.64-0.90)。Cochran Q 检验和 I 检验仅显示轻度异质性(P=0.12,I=38%)。在亚组分析中,北美地区的汇总 OR 为 0.67(95%CI=0.54-0.82)。按平均随访时间进行的亚组分析中,小于 5 年的汇总 OR 为 0.46(95%CI=0.28-0.74)。总之,减重手术对降低胰腺癌有积极作用,尤其是在北美地区。这种作用可能会随着时间的推移而减弱或消失。

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