饮茶与结直肠癌发病风险关系meta分析

Tea consumption and risk of colorectal cancer:a meta-analysis

目的探讨饮茶与结直肠癌发病风险的关系,为结直肠癌的预防控制提供科学依据。方法检索中国知网数据库、万方数据知识服务平台、维普数据库、PubMed数据库、Web of Science数据库、Springer Link数据库,并辅以文献追溯法收集各数据库建库至2019年4月1日国内外公开发表的有关饮茶与结直肠癌发病风险的相关文献;应用Stata 12.0软件对纳入的文献进行meta分析。结果最终纳入15篇文献(中文文献5篇,英文文献10篇),均为病例对照研究,累计病例组10251例,对照组12865例。meta分析结果显示,饮茶量最高组人群结直肠癌的发病风险为饮茶量最低组人群的0.78倍(OR=0.78,95%CI=0.68~0.90),饮绿茶量最高组人群结直肠癌的发病风险为饮绿茶量最低组人群的0.66倍(OR=0.66,95%CI=0.56~0.79),饮红茶与结直肠癌发病风险无关(OR=0.74,95%CI=0.38~1.45);亚组分析结果显示,亚洲地区、病例来源于人群和医院、中文文献和肿瘤部位在结直肠亚组中饮茶均可降低结直肠癌的发病风险(均P<0.05),研究地区可能是异质性的主要来源(P<0.05);敏感性分析和发表偏倚检验结果显示,本次meta分析纳入的文献不存在发表偏倚,结果较为稳定。结论饮茶尤其是饮绿茶,可减少结直肠癌的发病风险。

Objective To evaluate the association between tea consumption and the risk of colorectal cancer(CRC)and to provide evidences for the CRC prevention.Methods We searched China National Knowledge Infrastructure(CNKI),Wanfang Database,China Sci-Tech Journal Database(VIP),PubMed,Web of Science and Springer Link databases for studies on the correlation between tea consumption and CRC incidence published till April 1st,2019 and supplementary manual tracing for some of the references was also conducted.Statistical analyses were performed with Stata 12.0 software.Results Totally 15 publications on case-control study(5 in Chinese and 10 in English),involving a total of 10251 cases and 12865 controls,were included the analysis.The meta-analysis results revealed a 22%reduction in CRC risk in the participants with the highest tea consumption versus those with the lowest(pooled odds ratio[OR]=0.78,95%confidence interval[95%CI]:0.68-0.90)and a 34%reduction in CRC risk in the participants with the highest green tea consumption versus those with the lowest(OR=0.66,95%CI:0.56-0.79);but no association of black tea consumption with CRC risk was found(OR=0.74,95%CI:0.38-1.45).Subgroup analysis demonstrated an inverse association between tea consumption and CRC risk for studies conducted in Asian population,for population-and hospital-based studies,for studies published in Chinese,and for studies not only on rectum cancer cases(P<0.05).The heterogeneity in the study results may related mainly to regional disparity of the studies(P<0.05).The results of the meta-analysis were stable based on sensitivity analysis and no significant publication bias was detected with Egger and Begg test.Conclusion The results of the metaanalysis suggest that tea consumption,especially green tea consumption,may reduce the risk of colorectal cancer.