非幽门螺杆菌与胆石症及胆道系统恶性肿瘤相关性Meta分析

The pathogenic role of non-pylori helicobacter species in cholelithiasis and bile duct malignancies: A meta-analysis

目的评价非幽门螺旋杆菌与胆石症及胆道系统肿瘤之间的关系。方法检索Pub Med、Embase及Cochrane Library系统数据库中发表时间为2002年6月至2015年1月的英文文献。用预先设计的数据表独立地提取相关数据。按纳入标准筛选后进行质量评分,提取临床效应指标,采用Rev Man软件对所纳入的数据进行荟萃分析。结果纳入11项研究共927例病人。非幽门螺杆菌与胆石症（OR=2.49,95%CI 1.52~4.09,P〈0.05）及胆道系统恶性肿瘤（OR=4.42,95%CI 2.66~7.35,P〈0.05）之间存在相关性。敏感性分析未见明显异质性因素（OR=9.02,95%CI 3.58~22.69,I2=0,P=0.77）。肝螺杆菌（OR=3.25,95%CI 1.83~5.77）、胆螺杆菌（OR=4.01,95%CI 2.35~6.86）分别与胆石症和恶性肿瘤之间具有相关性。结论非幽门螺杆菌在胆道系统良恶性疾病中具有高检出率,且肝、胆螺杆菌可能在胆道系统恶性肿瘤的发生发展中产生致病作用。

Objective To evaluate the association between non-pylori helicobacter and cholclithiasis and bile duet malignancies. Methods Related English literatures retrieved from PubMed, Embase and Cochrane Library during July 2002 and Janury 2015 had been included. Two reviewers implied the data extraction independently using predefined data form. All the included data were analyzed by RevMan software. Results A total of 927 patients in 11 studies were included. There was significant correlation between non-pylori helicobacter and cholelithiasis （OR=2.49, 95% CI 1.52-4.09, P〈0.05）and bile duct malignancies （OR=4.42, 95% CI 2.66-7.35, P〈0.05）. There, was not obvious heterogeneity among studies. H.hepaticus（OR=3.25,95%CI 1.83-5.77） and H.bilis（OR=4.01,95%CI 2.35-6.86） have correlation with cholelithiasis and bile duct malignancies respectively. Conclusion The meta-analysis not only supports the high presence of non-pylori helieobacter in patients with biliary benign and malignant diseases, but also suggests the evidence of H.bilis and H.hepaticus to bile duct malignancies.