5-氨基水杨酸对炎症性肠病相关性结肠癌和上皮内瘤变化学预防:Meta分析

The chemopreventive effect of 5-aminosalicylic acid on inflammatory bowel disease associated colonic cancer and dysplasia: a Meta-analysis

目的探讨5-氨基水杨酸(5-ASA)对炎症性肠病(IBD)相关性结肠癌(IBDACa)和上皮内瘤变(IBDADys)发生率的影响,评估5-ASA对IBDACa/Dys的化学预防作用。方法检索正式发表的关于5-ASA对IBDACa/Dys化学预防的临床研究。外文数据库包括PubMed(Medline)、EMCC、OVID、the Cochrane Library;中文数据库包括万方、维普、CNKI、谷歌学术搜索。将符合要求的文献利用统计软件RevMan统计OR值和95%CI。对研究设计类型、IBD类型进行亚组分析。结果共纳入14篇文献,其中10篇为病例对照研究,4篇为队列研究。结果显示:与未使用5-ASA相比,使用5-ASA患者的IBDACa和IBDADys发生率为50%,OR=0.50(95%CI:0.34～0.73),其中病例对照研究Meta分析结果示OR=0.30(95%CI:0.10～0.92),队列研究示OR=0.56(95%CI:0.37～0.85);使用5-ASA的溃疡性结肠炎(UC)患者发生UCCa/Dys的OR=0.45(95%CI:0.27～0.77),使用5-ASA的克罗恩病(CD)患者发生CDCa/Dys的OR=0.39(95%CI:0.16～0.97)。结论 5-ASA对IBDACa/Dys有化学预防作用。

Objective To investigate the chemopreventive effect of 5-aminosalicylic acid （5-ASA） on the inflamma- tory bowel disease-associated colonic cancer （IBDACa） and dysplasia （IBDADys）. Methods All clinical study arti- cles about ehemoprevention of 5-ASA on IBDACa/Dys were searched by PubMed （Medline） , EMCC, OVID, the Co- chrane Library, Wanfang Database, VIP, CNKI and Google Scholar, the OR values and its 95% CI were calculated by RevMan software. Results 14 articles were selected for Meta-anlalysis, including 10 case-control studies and 4 cohort studies. Compared with those who didn＇ t receive 5-ASA, the patients who received 5-ASA had a lower risk to develop IBDACa/Dys（ OR =0.50, 95%CI： 0.34 ~0.73）. The case-control studies showed an OR =0.30 （95% CI： 0.10 0.92）, and the cohort studies showed an OR =0.56 （95% CI： 0.37-0.85）. Both UC patients （OR =0.45, 95% CI ： 0.27 - 0.77） and CD patients （ OR = 0.39, 95% CI ： 0.16 - 0.97 ） who received 5-ASA were less likely to develop colonic cancer or dysplasia compared with those who didn＇ t receive 5-ASA. Conclusion 5-ASA has chemopreventive effect on IBDACa/Dys.