Wei Wei, Wang Juanhong, Yu Daihua, Liu Wei, Zong Lei
Department of Pathology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China.
Department of Intensive Care Unit, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China.
Front Oncol. 2024 Jul 22;14:1414946. doi: 10.3389/fonc.2024.1414946. eCollection 2024.
Acute appendicitis (AA) is one of the most prevalent acute abdominal diseases and appendectomy is the definitive treatment of appendicitis. However, whether appendicitis and appendectomy cause colorectal cancer (CRC) is controversial. The results of observational studies are contradictory, but randomized controlled trials (RCT) cannot be conducted.
Data of appendectomy, AA, and CRC were obtained from the IEU Open GWAS project. We selected several Genome-wide association studies (GWAS) summary statistics for CRC: statistics for colon cancer (CC) were obtained from MRC-IEU and Neale lab, respectively; statistics for rectum cancer (RC) were obtained from MRC-IEU and FinnGen, respectively; statistics for CRC were provided by Sakaue S et al. Mendelian randomization (MR) was used to evaluate the causal relationships between exposure and outcomes. Inverse variance weighting (IVW) was the most important analysis method. Meta-analysis was used to summarize the results of IVW to increase the reliability and sensitivity analysis was used to evaluate the robustness of the results.
According to the results of IVW, appendectomy did not increase risk of CC: MRC-IEU (OR:1.009, 95%CI:0.984-1.035, P=0.494), Neale lab (OR:1.016, 95%CI:0.993-1.040, P=0.174); Appendectomy also did not increase risk of RC: MRC-IEU(OR:0.994, 95%CI:0.974-1.014, P=0.538), FinnGen(OR:2.791, 95%CI:0.013-580.763, P=0.706); Appendectomy also did not increase risk of CRC: Sakaue S(OR:1.382, 95%CI:0.301-6.352, P=0.678). Appendicitis did not increase risk of CC: MRC-IEU(OR:1.000, 95%CI:0.999-1.001, P=0.641), Neale lab(OR:1.000, 95%CI:1.000-1.001, P=0.319); Appendicitis also did not increase risk of RC: MRC-IEU(OR:1.000, 95%CI:0.999-1.000, P=0.361), FinnGen(OR:0.903, 95%CI:0.737-1.105, P=0.321); Appendicitis also did not increase risk of CRC: Sakaue S (OR:1.018, 95%CI:0.950-1.091, P=0.609). The results of Meta-analysis also showed appendectomy (P=0.459) and appendicitis (P=0.999) did not increase the risk of CRC.
Appendectomy and appendicitis do not increase the risk of colorectal cancer. More clinical trials are needed in the future to verify the causal relationships.
急性阑尾炎(AA)是最常见的急性腹部疾病之一,阑尾切除术是阑尾炎的确定性治疗方法。然而,阑尾炎和阑尾切除术是否会导致结直肠癌(CRC)仍存在争议。观察性研究的结果相互矛盾,但无法进行随机对照试验(RCT)。
阑尾切除术、AA和CRC的数据来自IEU开放GWAS项目。我们选择了几项关于CRC的全基因组关联研究(GWAS)汇总统计数据:结肠癌(CC)的统计数据分别来自MRC-IEU和Neale实验室;直肠癌(RC)的统计数据分别来自MRC-IEU和芬兰基因研究;CRC的统计数据由坂江S等人提供。采用孟德尔随机化(MR)来评估暴露与结局之间的因果关系。逆方差加权(IVW)是最重要的分析方法。采用荟萃分析来汇总IVW的结果,以提高可靠性,并使用敏感性分析来评估结果的稳健性。
根据IVW的结果,阑尾切除术不会增加CC的风险:MRC-IEU(比值比:1.009,95%置信区间:0.984-1.035,P=0.494),Neale实验室(比值比:1.016,95%置信区间:)0.993-1.040,P=0.174);阑尾切除术也不会增加RC的风险:MRC-IEU(比值比:0.994,95%置信区间:)0.974-1.014,P=0.538),芬兰基因研究(比值比:2.791,95%置信区间:0.013-580.763,P=0.706);阑尾切除术也不会增加CRC的风险:坂江S(比值比:1.382,95%置信区间:0.301-6.352,P=0.678)。阑尾炎不会增加CC的风险:MRC-IEU(比值比:1.000,95%置信区间:0.999-1.001,P=0.641),Neale实验室(比值比:1.000,95%置信区间:1.000-1.001,P=0.319);阑尾炎也不会增加RC的风险:MRC-IEU(比值比:1.000,95%置信区间:0.999-1.000,P=0.361),芬兰基因研究(比值比:0.903,95%置信区间:0.737-1.105,P=0.321);阑尾炎也不会增加CRC的风险:坂江S(比值比:1.018,95%置信区间:0.950-1.091,P=0.609)。荟萃分析的结果也表明阑尾切除术(P=0.459)和阑尾炎(P=0.999)不会增加CRC的风险。
阑尾切除术和阑尾炎不会增加结直肠癌的风险。未来需要更多的临床试验来验证因果关系。