中国幽门螺杆菌感染与胃癌关系的Meta分析

Meta-analysis on Relationship Between Helicobacter Pylori Infection and Gastric Cancer

目的综合分析幽门螺杆菌(HP)感染与胃癌的关系方法计算机检索中国期刊全文数据库、万方数据库,检索时间从1995年1月至2005年12月。纳入HP感染与胃癌关系的病例对照研究。用Meta分析方法对数据进行处理,估计其综合OR值和95％CI。结果共纳入14个研究,其中以正常人为对照的研究11个,以胃炎病人为对照的研究3个。按对照来源进行亚组分析,结果表明正常人与病例相比差异有统计学意义[OR合并2．00,95％CI(1．25,3．20)],而胃炎病人与病例相比差异无统计学意义[OR合并1．54,95％CI(0．68,3．50)]。按胃癌的部位进行亚组分析,结果显示胃非贲门癌与对照的差异有统计学意义[OR合并3．60,95％CI(1．25,10．36)],而胃贲门癌与对照的差异无统计学意义[OR合并0．88,95%CI(0．56,1．39)]。结论HP感染与胃癌相关,导致各研究结果不一致的原因主要是胃癌的部位和对照的选择。

Objective To analyze the relationship between helicobacter pylori （HP） and gastric cancer. Methods We searched CNKI （Jan.1995-Dec.2005） and Wangfandatabase （Jan.1995-Dec.2005）. Case-control studies on relationship of helicobacter pylori infection and gastric cancer were collected. Meta-analysis method was used to sum up the odds ratio （OR） and 95%CI of these studies. Results We identified 14 case-control studies with 11 studies of healthy adults versus gastric cancer patients and 4 studies of gastritis versus gastric cancer patients. The results of subgroup analyses based on patients resource showed： statistical difference was founded between healthy adults and gastric cancer patients with pooled OR 2.00 and 95%CI 1.25 to 3.20; no statistical difference was founded between gastritis patients and gastric cancer patients with pooled OR 1.54 and 95%CI 0.68 to 3.50. The results of subgroup analyses based on locations of gastric cancer showed： statistical difference was founded between the non-cardiac gastric cancer patients and the control with pooled OR 3.60 and 95%CI 1.25 to 10.36; no statistical difference was found between cardiac gastric cancer patients and control with pooled OR 0.88 and 95%CI 0.56 to 1.39. Conclusion HP infection can be associated with gastric cancer, and the different conclusions of the 14 reports may be attributed to the locations of gastric cancer and the selection of controls.