胆囊结石病史与小肠肿瘤关系的Meta分析

Relationship between history of gallstone disease and small intestinal neoplasms:a Meta-analysis

目的探讨胆囊结石病史与小肠肿瘤的关系。方法计算机检索PubMed、EMBASE、webofScience、中国生物医学文献数据库等，收集各数据库从建库到2015年4月所有关于胆囊结石病史与小肠肿瘤关系的观察性研究。按照严格的纳入排除标准筛选文章后，提取资料，应用Stata11．0软件进行Meta分析。结果最终纳入文献8篇，其中队列研究4篇，样本量831209例，病例对照研究4篇，样本量105591例。Meta分析结果显示，胆囊结石病史可能增加小肠肿瘤的患病风险（OR=2．25，95％Cf：1．44～3．52，P=0．000）。按照肿瘤的类型进行亚组分析，结果认为胆囊结石病史既增加小肠恶性肿瘤（OR=2．11，95％CI：1．18～3．78，P=0．011），也增加小肠良性肿瘤（0R=2．00，95％CI：1．40～2．85，P=0．000）患病风险。按是否性胆囊切除进行亚组分析，未行胆囊切除的胆囊结石病患者（OR=1．30，95％CI：1．12～1．52，P=0．001）和行胆囊切除的胆囊结石患者（OR=2．25，95％CI：1．38～3．68，P=0．001），小肠肿瘤患病风险均增高。结论胆囊结石病史可能增加小肠肿瘤患病风险。

Objective To investigate the relationship between history of gallstone disease and risk of small intestinal neo- plasms. Methods Literature databases of PubMed,EMBASE,Weh of Science,and CBM,etc. were searched for all relevant studies up to April 2015. After selecting literatures according to inclusion and exclusion criteria,data were extracted,and Stata 11.0 soft- ware was used for Meta-analysis. Results There were 8 studies including 4 cohort studies with 831 209 population and 4 case-con- trol studies With 105 591 participants,met the inclusion criteria. Meta-analysis showed that, history of gallstone disease might in- crease risk of small intestinal neoplasms （OR = 2.25,95 % CI： 1.44 -- 3.52 , P = 0. 000）. Subgroup analysis according to the type of tumour showed, risk increased not only in small intestinal adenocarcinomas （OR = 2.11,95 % CI： 1.18 -- 3.78, P = 0.011 ）, but also in small intestinal carcinoid tumours（OR： 2, 00,95 %CI：1.40--2.85, P= 0. 000）. Subgroup analysis on the basis of whether gallstone patients have cholecystectomy showed,risk of small intestinal neoplasms all increased in gallstone patients without cholecystectomy （OR = 1.30,95 % CI .. 1.12 -- 1.52, P = 0. 001 ）, and in gallstone patients with cholecysteetomy（OR = 2.25,95 % CI ： 1.38 -- 3.68, P = 0. 001）. Conclusion History of gallstone disease may increase risk of small intestinal neoplasms.