胆囊切除与结直肠腺瘤相关性的Meta分析

Meta- analysis of association between cholecystectomy and colorectal adenoma

目的有胆囊切除史的患者已被认为是我国结直肠癌早期筛查的高危人群，但国内外对胆囊切除与结直肠腺瘤（结直肠癌癌前病变）的相关性研究较少。采用Meta分析方法对国内外已发表的有关胆囊切除与结直肠腺瘤关系的研究进行综合评价。方法对符合纳入标准的13篇文献按研究方法不同分为队列研究组（6篇）和病例对照研究组（7篇），均使用Review manager 5.2软件进行Meta分析，计算前者的相对危险度（RR）和后者的比值比（OR），以及二者的95％可信区间（CI）。结果队列研究组和病例对照研究组分别纳入总样本量5940例和158 995例，Meta分析综合RR=1.32，95%CI：1.07~1.61；OR=1.17,95%CI：1.08~1.26。结论胆囊切除导致结直肠腺瘤发生的危险性增加。

ObjectivePatients with a history of cholecystectomy have been thought to be the high-risk population in early colorectal cancer screening in China. However, there are relatively few studies on the association between cholecystectomy and colorectal adenoma （precancerous lesions of colorectal cancer） around the world. The aim of this paper is to comprehensively evaluate the studies on the relationship between cholecystectomy and colorectal adenoma published both at home and abroad by meta-analysis. MethodsThirteen studies which met the inclusion criteria were divided into cohort study group （n=6） and case-control study group （n=7） according to research methods. A meta-analysis was performed using Review manager 5.2 software to calculate the relative risk （RR） of the cohort study group and the odds ratio （OR） of the case-control study group, as well as their 95% confidence intervals （CI）. ResultsA total of 5940 cases and 158 995 cases were included in the cohort study group and case-control group, respectively. The meta-analysis revealed a positive association between cholecystectomy and colorectal adenoma （RR=1.32, 95% CI： 1.07-1.61; OR=1.17, 95% CI： 1.08-1.26）. ConclusionCholecystectomy leads to an increase in the risk of colorectal adenoma.