胃食管反流病与喉鳞状细胞癌相关性研究Meta分析

发布时间：2018-08-01 14:40

【摘要】：目的:采用Meta分析的方法系统评价胃食管反流病和喉鳞状细胞癌的关系,为喉鳞状细胞癌的预防和治疗提供更好的科学依据。方法:全面检索PubMed、Embase、Web of Knowledge、CNKI、万方、维普和CBM数据库。制定纳入排除标准对文献进行筛选,并采用Newcastle-Ottawa Scale(NOS)标准对纳入文献进行质量评价。使用SAS 9.2统计学软件对数据进行χ2检验和Fisher确切概率法计算P值,用Stata 10统计软件进行Meta分析。根据异质性检验的结果选择模型合并各研究的OR值,并对合并后的结果进行发表偏倚评价和敏感性分析。结果:本研究共纳入9篇文献,包括32 348例喉癌患者和86 694名非喉癌患者。胃食管反流病在两组人群中的患病率分别为21.0%和11.0%。纳入的各文献质量均较高。合并后的OR值为2.01(95%CI:1.35~2.99),P0.001。漏斗图和Egger检验均未发现明显的发表偏倚。亚组分析显示,胃食管反流病与喉癌的关联仅见于美国人群,合并后的OR值为1.71(95%CI:1.06~2.76),P0.05。研究设计时对相关混杂因素进行匹配的亚组合并后的OR值略低于未匹配亚组。剔除两个大样本研究资料后,本研究结论不受影响。敏感分析结果显示,本研究结论稳定。结论:胃食管反流病与喉鳞状细胞癌的发生相关。
[Abstract]:Objective: to evaluate the relationship between gastroesophageal reflux disease (GERD) and laryngeal squamous cell carcinoma (LSCC) by Meta analysis. Methods: a comprehensive search of the PubMedus Embase Web of knowledge CBM, Wanfang, Wiper and CBM databases was carried out. The inclusion exclusion criteria were established to screen the literature and the Newcastle-Ottawa Scale (NOS) criteria were used to evaluate the quality of the included documents. 蠂 2 test and Fisher exact probability method were used to calculate P value by SAS 9.2 statistical software, and Meta analysis was performed by Stata 10 software. According to the results of heterogeneity test, the OR values of each study were selected, and the published bias evaluation and sensitivity analysis of the combined results were carried out. Results: this study included 9 articles, including 32 348 laryngeal cancer patients and 86 694 non-laryngeal cancer patients. The prevalence of gastroesophageal reflux disease in the two groups was 21.0% and 11.0%, respectively. The quality of the literature included was higher. The combined OR value was 2.01 (95%CI:1.35~2.99) P 0.001. Neither funnel graph nor Egger test showed any obvious bias of publication. Subgroup analysis showed that the association between gastroesophageal reflux disease and laryngeal cancer was only found in American population, and the OR value after the combination was 1. 71 (95%CI:1.06~2.76) P 0. 05. The OR value of the subgroup with matching the relevant confounding factors was slightly lower than that of the unmatched subgroup. After two large samples were excluded, the conclusion of this study was not affected. The results of sensitivity analysis show that the conclusion of this study is stable. Conclusion: gastroesophageal reflux disease is associated with laryngeal squamous cell carcinoma.
【作者单位】：中国医科大学流行病学教研室·辽宁省高校肿瘤病因与预防重点实验室;中国医科大学循证医学中心;中国医科大学附属盛京医院临床流行病学教研室;
【分类号】：R739.65

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