Zhang Xi, Yan Min
Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, Sichuan Province, China.
Beijing Anzhen Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, Sichuan Province, China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44395. doi: 10.1097/MD.0000000000044395.
While observational studies have identified associations between gastroesophageal reflux disease (GERD) and laryngeal cancer (LC), the causal direction remains undetermined. This study employed a bidirectional 2-sample Mendelian randomization (MR) approach complemented by meta-analysis to investigate potential causal relationships between GERD and LC. Analysis leveraged publicly accessible genome-wide association study resources. Instrumental variables meeting MR assumptions were rigorously selected. The inverse variance weighted method served as primary analysis, with horizontal pleiotropy assessed through MR-Egger intercept tests. Sensitivity evaluations included Cochran Q test for heterogeneity and leave-one-out analysis. Findings from multiple databases were consolidated via meta-analysis. Inverse variance weighted estimates demonstrated no significant causal effect of GERD on LC risk (odds ratio [OR] = 1.11, 95% confidence interval [CI] = 0.83-1.48). In addition, reverse MR analysis revealed no causal impact of LC genetic liability on GERD development (odds ratio = 1.01, 95% CI = 0.99-1.02). All sensitivity analyses supported consistent results. This bidirectional MR investigation provides no genetic evidence for causal associations between GERD and LC in either direction.
虽然观察性研究已经确定了胃食管反流病(GERD)与喉癌(LC)之间的关联,但因果关系方向仍未确定。本研究采用双向双样本孟德尔随机化(MR)方法并辅以荟萃分析,以研究GERD与LC之间的潜在因果关系。分析利用了公开可用的全基因组关联研究资源。严格选择符合MR假设的工具变量。逆方差加权法作为主要分析方法,通过MR-Egger截距检验评估水平多效性。敏感性评估包括异质性的Cochran Q检验和留一法分析。通过荟萃分析整合来自多个数据库的结果。逆方差加权估计表明,GERD对LC风险无显著因果效应(优势比[OR]=1.11,95%置信区间[CI]=0.83-1.48)。此外,反向MR分析显示,LC遗传易感性对GERD发生无因果影响(优势比=1.01,95%CI=0.99-1.02)。所有敏感性分析均支持一致的结果。这项双向MR研究没有提供GERD与LC之间双向因果关联的遗传证据。