手机使用与胶质瘤发病率关系的荟萃分析

Long-term use of mobile phone and its association with glioma： a systematic review and meta-analysis

目的 明确手机使用与胶质瘤的循证医学证据及研究现状并分析两者的关系,尤其是长期手机使用与胶质瘤的关系.方法 按照Cochrane系统综述方法,制定前瞻性研究方案并在PROSPERO网站进行注册,行文献检索、选择与数据摘录,并用RevMan软件对合并效应量进行统计分析,分别从时间、部位和肿瘤级别三个维度考察手机使用与胶质瘤间的关系.结果 证据提示,同侧长期使用手机与胶质瘤患病风险呈现正相关（P＜0.01）,合并效应量OR值为1.46[1.12,1.92].使用手机可提高低级别胶质瘤患病风险（P＜0.01）,长期使用风险明显增加（P＜0.01）,合并OR值分别为1.23[1.08,1.40]和2.27[1.81,2.85].但未见与高级别胶质瘤明显相关.结论 长期使用手机可能提高低级别胶质瘤患病风险.当前相关循证医学证据质与量都较差,有必要针对长期同侧手机使用因素开展前瞻性、大样本、跨种族人群的高质量研究。

Objective The hypothesis that ＂cell phone induces brain tumor＂ has become a target of much controversy for several decades and is still a matter of debate even now.We aim to make a systematic review and meta-analysis based on published studies on glioma to identify current evidences for evaluating mobile phones and glioma risk,especially on long-term use of mobile phones.Methods The study was conducted according to the Cochrane systematic review methods and reported according to the PRISMA （Preferred Reporting Items for Systematic reviews and Meta-Analyses） statement according to a prospective research protocol accessed via http：//www.crd.york.ac.uk/prospero.The software RevMan 5 was used for statistic analysis.Latency and lateralization were used for the examining the dose-response relationship.Results Overall evidence suggested the increased risk of glioma among long-term ipsilateral users of mobile phone with an odds ratio （OR） of 1.46 [1.12,1.92] based on meta-analysis.Especially,for low-grade glioma,long-term use yielded an OR value of 2.27 [1.81,2.85].Conclusion The evidence is currently insufficient on this issue,especially on long-term use of mobile phone.Neither a definite answer nor a clear explanation may be offered for the relationship.And larger prospective trials are warranted.