CAJ | 학술논문

目的：应用 Meta 分析评价叶酸水平与食管癌的相关性。方法检索中国期刊全文数据库（CNKI）、万方生物医学期刊数据库、维普中文科技期刊数据库（VIP）、PubMed 等数据库，收集2005－2014年国内外公开发表的关于叶酸水平与食管癌的相关性研究的文献。将所纳入的文献按食管癌病理类型不同、叶酸来源不同、实验人群所处地域不同进行分组，应用 Review Manager5．3软件进行统计学分析，效应量为比值比（OR ），并计算95％可信区间（95％ CI ），检验异质性，根据异质性检验结果选择应用固定效应模型或随机效应模型进行分析处理。结果本研究最终纳入13篇相关文献，病例组共2830人，对照组共8690人。Meta 分析结果显示，各研究间存在统计学异质性，采用随机效应模型进行描述，病例组与对照组叶酸水平的差异有统计学意义（OR ＝0．51，95％ CI ：0．37～0．69，Z ＝4．26，P ＜0．0001）。亚组分析显示，叶酸水平与食管鳞癌（ESCC）的发生有关系（P ＝0．005）；膳食叶酸摄入水平及血清叶酸水平均与食管癌的发生有关系（膳食叶酸：P ＝0．004，血清叶酸：P ＜0．0001）；亚洲人群的叶酸水平与食管癌的发生有关系（P ＜0．00001），但在非亚洲人群的研究中尚不能表明叶酸水平与食管癌的发生有关系（P ＝0．05）。结论叶酸水平与食管癌发病风险呈负相关，叶酸为食管癌发生的保护因素。
목적：응용 Meta 분석평개협산수평여식관암적상관성。방법검색중국기간전문수거고（CNKI）、만방생물의학기간수거고、유보중문과기기간수거고（VIP）、PubMed 등수거고，수집2005－2014년국내외공개발표적관우협산수평여식관암적상관성연구적문헌。장소납입적문헌안식관암병리류형불동、협산래원불동、실험인군소처지역불동진행분조，응용 Review Manager5．3연건진행통계학분석，효응량위비치비（OR ），병계산95％가신구간（95％ CI ），검험이질성，근거이질성검험결과선택응용고정효응모형혹수궤효응모형진행분석처리。결과본연구최종납입13편상관문헌，병례조공2830인，대조조공8690인。Meta 분석결과현시，각연구간존재통계학이질성，채용수궤효응모형진행묘술，병례조여대조조협산수평적차이유통계학의의（OR ＝0．51，95％ CI ：0．37～0．69，Z ＝4．26，P ＜0．0001）。아조분석현시，협산수평여식관린암（ESCC）적발생유관계（P ＝0．005）；선식협산섭입수평급혈청협산수평균여식관암적발생유관계（선식협산：P ＝0．004，혈청협산：P ＜0．0001）；아주인군적협산수평여식관암적발생유관계（P ＜0．00001），단재비아주인군적연구중상불능표명협산수평여식관암적발생유관계（P ＝0．05）。결론협산수평여식관암발병풍험정부상관，협산위식관암발생적보호인소。
Objective A Meta-analysis was used to evaluate the relationship between folate levels and esoph-ageal cancer.Methods CNKI, Wanfang Data, VIP, Pubmed databases were searched for studies published from 2005 to 2014 on the association between folate levels and esophageal cancer.The Review Manager 5.3 software was used for meta-analysis.Results were described as odds ratios (OR)with 95%confidence intervals (CI).According to the result of the heterogeneity test,the fixed effect model or ran-dom effect model was used for merge analysis.Results A total of 13 case-control studies involving 2 830 cases and 8 690 controls were included in the meta-analysis.Meta-analysis showed that there was significant heterogeneity between studies,folate levels was inversely associated with esophageal cancer risk (OR =0.51,95% CI :0.37 ~ 0.69,Z =4.26,P <0.000 1).Subgroup analysis showed that folate levels was negatively correlated with esophageal squamous cell carcinoma (ESCC)(P =0.005);Similarly dietary fo-late intake levels and serum folate levels were negatively correlated with esophageal cancer (dietary folate: P =0.004,serum folate (P <0.000 1);In the Asian group,there was negative correlation between the risk of esophageal cancer and folate levels (P <0.000 01),however such a correlation was not found in non-Asian group (P =0.05).Conclusion The current meta-analysis demonstrates that the folate levels is inversely associated with esophageal cancer risk,folic acid is a protective factor for esophageal cancer.