临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2014年
8期
877-881
,共5页
许松欣%丁岩冰%陈姚生%邓彬
許鬆訢%丁巖冰%陳姚生%鄧彬
허송흔%정암빙%진요생%산빈
结直肠肿瘤%幽门螺杆菌%meta 分析
結直腸腫瘤%幽門螺桿菌%meta 分析
결직장종류%유문라간균%meta 분석
colorectal neoplasms%helicobacter pylori%meta-analysis
目的:采用 meta 分析方法对国内外已发表的有关东方国家人群中幽门螺杆菌(Hp)感染与结直肠肿瘤(包括增生性息肉、腺瘤、肠癌)的关系进行综合评价。方法对符合纳入标准的8篇文献用 Review manager 5.2软件进行 meta 分析,选择 OR 值及95% CI 作为 meta 分析指标。并做出倒漏斗图,对各研究结果进行异质性检验和效应值合并计算。结果纳入总样本量为5385例,其中 Hp 阳性组为3396例,Hp 阴性组为1989例;通过 meta 分析合并认为结果存在异质性(I 2=83%,P <0.10)。因存在异质性,对肿瘤的类型(增生性息肉、腺瘤、肠癌)、不同的 Hp 检测方法进行亚组分析。①Hp 感染不增加患增生性息肉、结直肠非进展性腺瘤、肠癌的风险(OR =0.73,95% CI =0.45~1.17;OR =1.35,95% CI =0.98~1.86;OR =1.09,95% CI =0.71~1.68),而增加了患结直肠腺瘤及进展性腺瘤的风险(OR =1.81,95% CI =1.31~2.49;OR =2.02,95% CI =1.38~2.96);②采用血清学抗体检测出的Hp 感染可增加患结直肠肿瘤的风险(OR =1.49,95% CI =1.00~2.22);③采用非血清学抗体检测出的 Hp 感染无明显增加患肿瘤的风险(OR =1.35,95% CI =0.89~2.07)。结论 Hp 感染可能增加了结直肠腺瘤及进展性腺瘤的发生风险,但无明显增加患肠癌的风险。
目的:採用 meta 分析方法對國內外已髮錶的有關東方國傢人群中幽門螺桿菌(Hp)感染與結直腸腫瘤(包括增生性息肉、腺瘤、腸癌)的關繫進行綜閤評價。方法對符閤納入標準的8篇文獻用 Review manager 5.2軟件進行 meta 分析,選擇 OR 值及95% CI 作為 meta 分析指標。併做齣倒漏鬥圖,對各研究結果進行異質性檢驗和效應值閤併計算。結果納入總樣本量為5385例,其中 Hp 暘性組為3396例,Hp 陰性組為1989例;通過 meta 分析閤併認為結果存在異質性(I 2=83%,P <0.10)。因存在異質性,對腫瘤的類型(增生性息肉、腺瘤、腸癌)、不同的 Hp 檢測方法進行亞組分析。①Hp 感染不增加患增生性息肉、結直腸非進展性腺瘤、腸癌的風險(OR =0.73,95% CI =0.45~1.17;OR =1.35,95% CI =0.98~1.86;OR =1.09,95% CI =0.71~1.68),而增加瞭患結直腸腺瘤及進展性腺瘤的風險(OR =1.81,95% CI =1.31~2.49;OR =2.02,95% CI =1.38~2.96);②採用血清學抗體檢測齣的Hp 感染可增加患結直腸腫瘤的風險(OR =1.49,95% CI =1.00~2.22);③採用非血清學抗體檢測齣的 Hp 感染無明顯增加患腫瘤的風險(OR =1.35,95% CI =0.89~2.07)。結論 Hp 感染可能增加瞭結直腸腺瘤及進展性腺瘤的髮生風險,但無明顯增加患腸癌的風險。
목적:채용 meta 분석방법대국내외이발표적유관동방국가인군중유문라간균(Hp)감염여결직장종류(포괄증생성식육、선류、장암)적관계진행종합평개。방법대부합납입표준적8편문헌용 Review manager 5.2연건진행 meta 분석,선택 OR 치급95% CI 작위 meta 분석지표。병주출도루두도,대각연구결과진행이질성검험화효응치합병계산。결과납입총양본량위5385례,기중 Hp 양성조위3396례,Hp 음성조위1989례;통과 meta 분석합병인위결과존재이질성(I 2=83%,P <0.10)。인존재이질성,대종류적류형(증생성식육、선류、장암)、불동적 Hp 검측방법진행아조분석。①Hp 감염불증가환증생성식육、결직장비진전성선류、장암적풍험(OR =0.73,95% CI =0.45~1.17;OR =1.35,95% CI =0.98~1.86;OR =1.09,95% CI =0.71~1.68),이증가료환결직장선류급진전성선류적풍험(OR =1.81,95% CI =1.31~2.49;OR =2.02,95% CI =1.38~2.96);②채용혈청학항체검측출적Hp 감염가증가환결직장종류적풍험(OR =1.49,95% CI =1.00~2.22);③채용비혈청학항체검측출적 Hp 감염무명현증가환종류적풍험(OR =1.35,95% CI =0.89~2.07)。결론 Hp 감염가능증가료결직장선류급진전성선류적발생풍험,단무명현증가환장암적풍험。
Objective Meta-analysis was used to evaluate the relationship between Helicobacter pylori (Hp) infection and colorectal neoplasm (including hyperplastic polyps,adenomas and colorectal cancer)in eastern countries. Methods To analyze eight references meeting eligibility criteria with reviewing manager 5.2 software,we selected the OR and 95% CI as indicators of meta-analysis.A funnel geometry figure was made,and the heterogeneity inspection results and effect value were calculated.Results A total sample of 5 385 cases,including 3 396 cases in Hp positive group,1 989 cases in Hp negative group;Meta-analysis merger showed(I 2 =83%,P <0.10).Due to the existence of heterogeneity,subgroup analysis about tumor type (hyperplastic polyps,adenomas and colorectal cancer)and detection methods were evaluated.① Hp infection did not increase the risk of occurrence of hyperplastic polyp,non-advanced adenoma,colorectal cancer (OR =0.73,95% CI =0.45-1.17;OR =1.35,95% CI =0.98-1.86,OR =1.09,95% CI =0.71-1.68),but Hp infection increased the risk of colorectal adenoma and advanced adenoma(OR =1.81,95% CI =1.31-2.49,OR =2.02,95% CI = 1.38-2.96);②The serological antibody detection of Hp infection indicated an increasing risk of colorectal neoplasia (OR = 1.49,95% CI = 1.00-2.22 );③ The non-serological antibody test showed no increasing risk of colorectal neoplasia (OR =1.35,95% CI =0.89-2.07).Conclusion Hp infection may be a risk of colorectal advanced adenoma,but not of colorectal cancer.