DupA与十二指肠溃疡相关性的荟萃分析

Association between DupA and duodenal ulcer:a meta-analysis

目的系统评价十二指肠溃疡(DU)与其他胃十二指肠疾病[胃炎(GS)、胃溃疡(GU)和胃癌(GC)]间十二指肠溃疡促进基因(DupA)表达的差异。方法系统检索电子数据库(PubMed、Embase和Web of Science;检索时间均为建库至2020年1月)、相关文献的参考文献综述以及在相关科学协会会议上发表的摘要。随后根据纳人标准纳人相关研究并进行质量和偏倚风险评估。DU和其他胃十二指肠疾病(包括GS、GU和GC)中DupA频率的差异通过计算合并的比值比(0R)和95%可信区间(CI)分析。通过Galbraith图的方法评估异质性的来源。通过Begg漏斗图和Egger检验分析发表偏倚。结果最终的荟萃分析共包括25项研究。合并OR和95%CI在总体人群中显示出DupA与DU更相关(DU vs.GS:OR=2.02,95%CE=1.47~2.78;DU vs.GU:0R=1.82,95%CE=1.08~3.06;DU vs.GC:OR=2.66,95%CI=1.52~4.66)。亚组分析显示在亚洲人群和南美人群也存在上述相关性,而在白种人亚组中则没有。结论与其他胃十二指肠疾病(包括GS、GU和GC)相比,DupA与DU的关联性更高,提示DupA是DU有希望的特异性毒力标记物,特别是对于亚洲人群。

Objective To explore the difference in expression of duodenal ulcer-promoting gene(DupA)between duodenal ulcer(DU)and other gastroduodenal disorders including gastritis(GS),gastric ulcer(GU)and gastric cancer(GC).Methods Systematic search of electronic databases(PubMed,Embase and Web of Science,with search period from database establishment to January 2020),reference lists,reviews and the abstracts presented at related scientific societies meetings was performed.Studies were included according to inclusion criteria and the quality and risk of bias assessment was performed.Pooled odds ratios(OR)with 95%confidence intervals(CI)were calculated to analyze the difference of frequency of DupA in DU and other gastroduodenal disorders including GS,GU and GC.Galbraith plot was created for graphically assessing the source of heterogeneity.Publication bias was analyzed by Begg's funnel plot and Egger's test.Results A total of 25 studies were included in the final meta-analysis.The pooled OR and 95%CI showed significant associations in the overall population(for DU vs.GS:OR=2.02,95%CI=1.47~2.78;.for DU vs.GU:OR=1.82,95%CI=1.08~3.06;for DU vs.GC:OR=2.66,95%CI=1.52~4.66).In addition,significant associations were found in Asian and South American subgroups,but not in Caucasian subgroup.Conclusion DupA is more associated with DU than other gastroduodenal disorders including GS,GU and GC.It would be a promising specifie virulence marker for DU,especially for Asian.