Zheng Zeyi, Lu Ziyu, Song Yani
School of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
School of Basic Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
Front Pharmacol. 2023 Aug 25;14:1244400. doi: 10.3389/fphar.2023.1244400. eCollection 2023.
Long-term maintenance therapy with proton pump inhibitors (PPIs) is a common treatment strategy for acid-related gastrointestinal diseases. However, concerns have been raised about the potential increased risk of gastric cancer and related precancerous lesions with long-term PPI use. This systematic review and meta-analysis aimed to evaluate this potential risk. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomised controlled trials published before 1 March 2023, with no language restrictions. The primary endpoint was the occurrence and progression of gastric mucosal atrophy, intestinal metaplasia, Enterochromaffin-like (ECL) cell hyperplasia, gastric polyps, and gastric cancer during the trial and follow-up. Data were analysed using a random effects model. Of the 4,868 identified studies, 10 met the inclusion criteria and were included in our analysis, comprising 27,283 participants. Compared with other treatments, PPI maintenance therapy for more than 6 months was associated with an increased risk of ECL cell hyperplasia (OR 3.01; 95% CI 1.29 to 7.04; = 0.01). However, no significant increase was found in the risk of gastric mucosal atrophy (OR 1.01; 95% CI 0.55 to 1.85; = 0.97), intestinal metaplasia (OR 1.14; 95% CI 0.49 to 2.68; = 0.76), gastric polyps (OR 1.13; 95% CI 0.68 to 1.89; = 0.64), or gastric cancer (OR 1.06; 95% CI 0.79 to 1.43; = 0.71). This systematic review and meta-analysis does not support an increased risk of gastric cancer or related precancerous lesions with long-term PPI maintenance therapy. However, long-term PPI use should be monitored for potential complications such as ECL cell hyperplasia. Further studies are needed to confirm these findings and evaluate the safety of PPI maintenance therapy for acid-related gastrointestinal diseases. https://www.crd.york.ac.uk/prospero/, Identifier: PROSPERO (CRD42022379692).
质子泵抑制剂（PPI）的长期维持治疗是酸相关性胃肠道疾病的常见治疗策略。然而，长期使用PPI会增加胃癌及相关癌前病变的潜在风险，这一点已引起关注。本系统评价和荟萃分析旨在评估这一潜在风险。我们检索了PubMed、Embase和Cochrane对照试验中心注册库，以查找2023年3月1日前发表的随机对照试验，无语言限制。主要终点是试验期间及随访期间胃黏膜萎缩、肠化生、嗜铬样（ECL）细胞增生、胃息肉和胃癌的发生及进展情况。采用随机效应模型进行数据分析。在4868项确定的研究中，10项符合纳入标准并纳入我们的分析，共27283名参与者。与其他治疗相比，PPI维持治疗超过6个月与ECL细胞增生风险增加相关（比值比[OR] 3.01；95%置信区间[CI] 1.29至7.04；P = 0.01）。然而，未发现胃黏膜萎缩风险（OR 1.01；95% CI 0.55至1.85；P = 0.97）、肠化生风险（OR 1.14；95% CI 0.49至2.68；P = 0.76）、胃息肉风险（OR 1.13；95% CI 0.68至1.89；P = 0.64）或胃癌风险（OR 1.06；95% CI 0.79至1.43；P = 0.71）有显著增加。本系统评价和荟萃分析不支持长期PPI维持治疗会增加胃癌或相关癌前病变的风险。然而，长期使用PPI时应监测ECL细胞增生等潜在并发症。需要进一步研究来证实这些发现，并评估PPI维持治疗酸相关性胃肠道疾病的安全性。https://www.crd.york.ac.uk/prospero/，标识符：PROSPERO（CRD42022379692）
Zotero 插件
