Min Yu, Liu Zheran, Li Ruidan, Jin Jing, Wei Zhigong, Pei Yiyan, Hu Xiaolin, Peng Xingchen
Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Cheng Du, Sichuan, China.
West China School of Nursing, West China Hospital, Sichuan University, Cheng Du, Sichuan, China.
Front Oncol. 2023 Aug 23;13:1155123. doi: 10.3389/fonc.2023.1155123. eCollection 2023.
The nuanced relationship between inflammatory bowel disease (IBD) and pancreatic cancer is noticed in recent years. However, the underlying causal effects of these two diseases are still unclear.
The two-sample mendelian randomization (MR) was conducted to explore the causal effect of IBD condition on pancreatic cancer. Methods of Wald ratio, inverse variance weighted (IVW), MR-Egger, weighted median, and weighted mode were used to investigate the causal relationship between IBD and pancreatic cancer. Besides, Cochrane's Q test, MR-Egger, and leave-one-out method were further conducted to detect heterogeneity, stability, and pleiotropy of MR results.
In the MR analysis, we found Crohn's disease had a significant causal effect on pancreatic cancer. Specifically, Crohn's disease would increase 11.1% the risk of pancreatic cancer by the IVW method (p= 0.022), 33.8% by MR Egger (p= 0.015), by 35.3% by the Weighted model (p= 0.005). Regarding ulcerative colitis, there was no statistically significant causal effect observed on pancreatic cancer (p>0.05). Additionally, the pleiotropic test and Leave-one-out analysis both proved the validity and reliability of the present two-sample MR analyses.
This study indicates that IBD, particularly Crohn's disease, is causality associated with increased risk of pancreatic cancer. Our results may help public health managers to make better follow-up surveillance of IBD patients.
近年来,炎症性肠病(IBD)与胰腺癌之间的细微关系受到关注。然而,这两种疾病的潜在因果关系仍不清楚。
采用两样本孟德尔随机化(MR)方法探讨IBD状态对胰腺癌的因果效应。使用Wald比率法、逆方差加权法(IVW)、MR-Egger法、加权中位数法和加权模式法研究IBD与胰腺癌之间的因果关系。此外,进一步进行Cochrane's Q检验、MR-Egger检验和留一法,以检测MR结果的异质性、稳定性和多效性。
在MR分析中,我们发现克罗恩病对胰腺癌有显著的因果效应。具体而言,通过IVW法,克罗恩病会使胰腺癌风险增加11.1%(p = 0.022);通过MR Egger法增加33.8%(p = 0.015);通过加权模型增加35.3%(p = 0.005)。对于溃疡性结肠炎,未观察到对胰腺癌有统计学显著的因果效应(p>0.05)。此外,多效性检验和留一法分析均证明了本两样本MR分析的有效性和可靠性。
本研究表明,IBD,尤其是克罗恩病,与胰腺癌风险增加存在因果关联。我们的结果可能有助于公共卫生管理人员对IBD患者进行更好的随访监测。