中国人群膀胱癌发病危险因素的Meta分析

Meta-analysis of the risk factors of bladder cancer in Chinese population

目的探讨中国人群膀胱癌发生的主要危险因素，为预防决策提供依据。方法以“bladder carcinoma”或“bladder neoplasm”、“smoking”和“膀胱癌”、“吸烟”、“咖啡”等为检索词，收集1979年1月至2005年6月国内外公开发表的关于膀胱癌发病危险因素的研究文献，并用RevMan软件对这些文献进行Meta综合定量；根据固定效应模型和随机效应模型计算结果的一致程度及失效安全系数进行敏感性分析。结果纳入本次Meta分析的文献共有23篇，累计病例7600例，对照5002例。膀胱癌发生的各危险因素合并相对危险度（OR）值及95％可信区间（95％CI）分别为：吸烟1．38（1．22—1．57）、接触化学物质1．95（1．74-2．19）、饮用酒精2．53（1．60—4．00）、饮用咖啡1．31（1．04—1．64）、膀胱癌家族及遗传史4．43（3．54—5．53）、性别4．12（3．71—8．14），P值均〈0．05。结论目前影响中国人群膀胱癌发生的主要因素为吸烟、接触化学物质、膀胱癌家族史、饮用酒精、咖啡及性别等。

Objective To provide evidence for decision-making on bladder cancer prevention through investigating the main risk factors related to the incidence of bladder cancer in Chinese population. Methods Using the search terms ＂bladder neoplasm＂ and ＂smoking＂, the literature from January 1979 to June 2005 on the relationship between risk factors and bladder carcinoma was searched from MEDLINE database and PubMed database, and was studied by Met,a-analysis. At the same time, ORs of randomized model and fixed model were calculated to evaluate the sensitivity. Results Totally,23 epidemiological studies on risk factors of bladder cancer were analyzed synthetically by Meta-analysis. The cumulative cases and controls were 7 600 and 5 002 ,respectively. The pooled odds ratio （OR） values and 95% CIs were as iollows ： smoking, 1.38 （ 1. 22 - 1.57 ） ; contactillg chemicals, 1.95 （ 1.74 - 2. 19 ） ; drinking alcohol, 2.53 （ 1.60 - 4.00 ） ; drinking coffee, 1.31 （ 1.04 - 1.64 ） ; family history of bladder cancer,4.43 （ 3.54 - 5.53 ） ; and gender,4.12 （3.71 8.14） ;respectively （P 〈 0.05 for all）. Conclusions The main factors influencing the incidence of bladder cancer in Chinese population are currently smoking, contacting chemicals, drinking alcohol and coffee, family history of bladder cancer, and gender.