Arg462Gln and Asp541Glu polymorphisms in ribonuclease L and prostate cancer risk:a meta-analysis

Objective：The association between ribonuclease L（RNASEL）gene polymorphisms and prostate cancer risk has been widely reported,but the results of these studies remained controversial and underpowered.We performed a meta-analysis of 28 studies to evaluate the association between Arg462Gln and Asp541Glu polymorphisms in the RNASEL gene and prostate cancer risk.Methods：Odds ratios（ORs）with 95%confidence intervals（CIs） were estimated to assess the association between RNASEL polymorphisms and prostate cancer risk.Results：A significantly increased prostate cancer risk was found for the Arg462Gln polymorphism in Africans（Gln/Gln vs Arg/Arg：OR=2.50,95%CI=1.28-4.87;Gln/Gln vs Gln/Arg＋Arg/Arg：OR=2.54,95%CI=1.30-4.95）,but not in Europeans and Asians.Additionally,the Asp541Glu polymorphism was associated with increased total prostate cancer risk（Glu-allele vs Asp-allele：OR=1.04,95%CI=1.01-1.07;Glu/Glu vs Asp/Asp：OR=1.22,95%CI= 1.03-1.46;Glu/Glu vs Glu/Asp＋Asp/Asp：OR=1.09,95%CI=1.02-1.16）.In the stratified analysis for the Asp541Glu polymorphism,there was a significantly increased prostate cancer risk in Africans and Europeans,and in hospital-based prostate cancer cases.Conclusion：The meta-analysis results showed evidence that RNASEL Arg462Gln and Asp541Glu polymorphisms are associated with prostate cancer risk and could be low-penetrance prostate cancer susceptibility biomarkers.

Helicobacter pylori infection and esophageal cancer risk:An updated meta-analysis

AIM:To clarify the association between Helicobacter pylori(H.pylori)infection and the risk of esophageal carcinoma through a meta-analysis of published data.METHODS:Studies which reported the association between H.pylori infection and esophageal cancer published up to June 2013 were included.The odds ratios(ORs)and corresponding 95%CIs of H.pyloriinfection on esophageal cancer with respect to health control groups were evaluated.Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator.The statistical software,STATA(version 12.0),was applied to investigate heterogeneity among individual studies and to summarize the studies.A meta-analysis was performed using a fixed-effect or random-effect method,depending on the absence or presence of significant heterogeneity.RESULTS:No significant association between H.pylori infection and esophageal squamous cell carcinoma(ESCC)risk was found in the pooled overall population(OR=0.97,95%CI:0.76-1.24).However,significant associations between H.pylori infection and ESCC risk were found in Eastern subjects(OR=0.66,95%CI:0.43-0.89).Similarly,cytotoxin-associated gene-A(CagA)positive strains of infection may decrease the risk of ESCC in Eastern subjects(OR=0.77,95%CI:0.65-0.92),however,these associations were not statistically significant in Western subjects(OR=1.26,95%CI:0.97-1.63).For esophageal adenocarcinoma(EAC)the summary OR for H.pylori infection and CagA positive strains of infection were 0.59(95%CI:0.51-0.68)and 0.56(95%CI:0.45-0.70),respectively.CONCLUSION:H.pylori infection is associated with a decreased risk of ESCC in Eastern populations and a decreased risk of EAC in the overall population.

Association between p21 Ser31Arg polymorphism and cancer risk:a meta-analysis

P21(CDKN1A),a key cell cycle regulatory protein that governs cell cycle progression from G1 to S phase,can regulate cell proliferation,growth arrest,and apoptosis.The Ser31Arg polymorphism is located in the highly conserved region of p21 and may encode functionally distinct proteins.Although many epidemiological studies have been conducted to evaluate the association between the p21 Ser31Arg polymorphism and cancer risk,the findings remain conflicting.This meta-analysis with 33 077 cases and 45 013 controls from 44 published case-control studies showed that the variant homozygous 31Arg/Arg genotype was associated with an increased risk of numerous types of cancers in a random-effect model(homozygote comparison:OR = 1.17,95% CI = 0.99 to 1.37,P = 0.0002 for the heterogeneity test;recessive model comparison:OR = 1.16,95% CI = 1.01 to 1.33,P = 0.0001 for the heterogeneity test).Stratified analysis revealed that increased cancer risk associated with the 31Arg/Arg genotype remained significant in subgroups of colorectal cancer,estrogen-related cancer,Caucasians,population-based studies,studies with matching information or a larger sample size.Heterogeneity analysis showed that tumor type contributed to substantial between-study heterogeneity(recessive model comparison:χ2 = 21.83,df = 7,P = 0.003).The results from this large-sample sized meta-analysis suggest that the p21 31Arg/Arg genotype may serve as a potential marker for increased cancer risk.

Prostate cancer risk and aggressiveness associated with the CYPIB1 4326C/G （Leu432Val） polymorphism： a meta-analysis of 2788 cases and 2968 controls

To derive a precise estimation of the associations between the cytochrome P450 1B 1 （CYPIB1） 4326C/G variants and prostate cancer （PCa） risk or aggressiveness, a meta-analysis was performed using all eligible published studies. Odds ratios （ORs） with 95% confidence intervals （CIs） were estimated to assess the association in seven literature studies with 2788 cases and 2968 controls. In the overall analysis, no significant association was found between the CYPIB1 4326C/G polymorphism and PCa risk, but ethnicity subgroup analyses and a case-source analysis revealed significant associations. The 4326G allele showed a significant association with increased PCa risk in Asians （OR= 1.52, 95% Ch 1.20-1.92）, and significant associations were also observed in a heterozygote comparison （OR= 1.40, 95% Ch 1.03-1.89）, a homozygote comparison （0R=2.38, 95% Ch 1.31-4.33） and in a dominant genetic model （OR = 1.52, 95% Ch 1.14-2.01）. Moreover, the 4326G allele was also significantly correlated with an increased risk of sporadic PCa （OR= 1.13, 95% Ch 1.04-1.24）, and significant associations were observed in a heterozygote comparison （OR= 1.16, 95% Ch 1.02-1.33）, a homozygote comparison （OR= 1.24, 95% Ch 1.03-1.49） and a dominant genetic model （OR= 1.19, 95% Ch 1.05- 1.34）. The overall analyses and all subgroup analyses showed no significant association between the 4326C/G polymorphism and PCa aggressiveness. Our meta-analysis showed that CYPIB1 4326G allele is significantly associated with an increased PCa risk in Asians and in sporadic PCa cases.

Relationship between apurinic endonuclease 1 Asp148Glu polymorphism and gastrointestinal cancer risk: An updated meta-analysis

AIM:To evaluate the relationship between apurinic endonuclease 1(APE1) Asp148 Glu polymorphism and the susceptibility to gastrointestinal(GI) cancers.METHODS:We searched Pub Med, ISI Web of Knowledge, and Chinese National Knowledge Infrastructure(CNKI) databases updated on July 15, 2014 for relevant studies.Only case-control studies comparing APE1 Asp148 Glu polymorphism and GI cancer risk were included.We excluded studies reporting only standardized incidence ratios without control groups and those without detailed genotyping data.Meta-analysis was performed on 17 studies involving 4856 cancer patients and 6136 cancer-free controls.Review Manager version 5.1 was used to perform the meta-analysis.The pooled odds ratios(ORs) and 95% confidence intervals(CIs) were estimated under the allele contrast, homozygous, heterozygous, dominant and recessive genetic models.We also conducted subgroup analyses stratified by ethnicity and cancer type.Publication bias was evaluated using Begg's test.RESULTS:The meta-analysis showed a significant association between APE1 Asp148Glu polymorphism and GI cancer risk in three genetic models in the overall population(G vs T:OR=1.18;95%CI:1.05-1.32;TG vs TT:OR=1.28;95%CI:1.08-1.52;TG+GG vs TT:OR=1.32;95%CI:1.10-1.57).Stratified analysis by ethnicity revealed a statistically increased GI cancer risk in Asians(G vs T:OR=1.27;95%CI:1.07-1.51;GG vs TT:OR=1.58;95%CI:1.05-2.38;TG vs TT:OR=1.30;95%CI,1.01-1.67;and TG+GG vs TT:OR=1.38;95%CI:1.07-1.78),but not in Caucasians.Furthersubgroup analysis by cancer type indicated that APE1Asp148Glu polymorphism may contribute to gastric cancer risk.However,Asp148Glu has no significant association with colorectal or esophageal cancer risk in any genetic model.CONCLUSION:This meta-analysis suggests that the APE1 Asp148Glu polymorphism G allele is associated with an increased GI cancer risk,especially in gastric cancer.

CXCL12 G801A Polymorphism and Cancer Risk: An Updated Meta-analysis

Many studies have reported the relationship between CXCL12 G801 A polymorphism and cancer risk, with conflicting results. In this study, we tried to clarify the possibility that this polymorphism may increase cancer risk by conducting an updated meta-analysis. Pub Med and EMbase were searched for case-control studies regarding the association of the gene polymorphism and cancer risk. Data were extracted and odds ratios（ORs） with 95% confidence intervals（95% CIs） were used to assess the strength of the association. Heterogeneity among articles and publication bias was also assessed. Significantly increased risk for cancer was found（A vs. G： OR=1.26, 95% CI=1.13-1.40, P〈0.01; AA＋AG vs. GG： OR=1.33, 95% CI=1.16-1.52, P〈0.01）. In subgroup analysis, statistically elevated cancer risk was found in both Asian and Caucasian populations（for Asian, AA＋AG vs. GG： OR=1.74, 95% CI=1.22-2.47, P〈0.01; for Caucasian, AA＋AG vs. GG： OR=1.24, 95% CI=1.09-1.42, P〈0.01）. Our result indicated that CXCL12 G801 A polymorphism is a risk factor for cancer. To validate the finding, further large-size case-control studies are warranted.

Association between p53 Pro72Arg polymorphism and prostate cancer risk:a meta-analysis

The tumor suppressor gene p53 appears to be important in the development of many human cancers, such as prostate cancer. The association of p53 codon72 polymorphism with prostate cancer has been widely reported; however, the results are inconsistent. To derive a more precise estimation of this relationship, we performed an updated meta-analysis from 10 case-control studies. We conducted a search in the PubMed database without a language limitation, covering all papers published until July 2010. Risk ratios （RR） with 95% confidence intervals （CIs） were used to assess the strength of the association. Ten studies including 1,196 cases and 1,704 controls were selected. Overall, no significant differences of total prostate cancer risk and p53 codon polymorphism was found （Pro/Pro vs Arg/Arg, RR = 1.12, 95%CI=0.74-1.70, P heterogeneity = 0.016, I 2 = 55.8%; Pro/Pro＋Pro/Arg vs Arg/ Arg, RR = 1.05, 95%CI=1.00-1.11, P heterogeneity = 0.077, I 2 = 51.1%）. In the stratified analysis by ethnicity, the same results were found. However, in the control subgroup, there was a modest decreased association between prostate cancer risk and population-based control subjects under the recessive genetic model （RR = 0.31, 95%CI=0.10- 0.91, P heterogeneity = 0.110, I 2 =60.8%）. This meta-analysis suggested that p53 codon Pro72Arg polymorphism could be weakly associated with prostate cancer risk.

Pre-existing diabetes mellitus increases the risk of gastric cancer:A meta-analysis

AIM:To systematically assess the association between diabetes and incidence of gastric cancer.METHODS:We searched MedLine (PubMed),EMBASE,and the Cochrane Library without any limitations with respect to publication date or language,we also searched the references of qualifying articles.Casecontrol studies and cohort studies comparing the risk of gastric cancer between diabetic patients and control subjects were included.We excluded studies reporting only standardized incidence ratios without control groups and those that investigated only mortality but not incidence.Seventeen studies met our criteria,and the qualities of these studies were assessed using theNewcastle-Ottawa Quality Assessment Scale.We performed a meta-analysis of pre-existing diabetes and gastric cancer incidence using the DerSimonian-Laird method for random-effects.For subgroup analyses,we separated the studies by study type,region,sex and method to determine confounding factors and reliability.We also conducted subgroup analyses to examine the effects of smoking,Helicobacter pylori (H.pylori) infection,and cancer site.Publication bias was evaluated using Begg's test.RESULTS:A random-effects model meta-analysis showed an increased gastric cancer risk in diabetic patients [relative risk (RR)=1.19;95%CI:1.08-1.31].Subgroup analyses indicated that this result persisted in cohort studies (RR=1.20;95%CI:1.08-1.34),in studies on populations of both Western (RR=1.18;95%CI:1.03-1.36) and Eastern countries (RR=1.19;95%CI:1.02-1.38),in a female subgroup (RR=1.24;95%CI:1.01-1.52),and in highly qualified studies (RR=1.17;95%CI:1.05-1.31).Moreover,these results persisted when the analysis was confined to studies adjusted for well-known gastric cancer risk factors such as smoking (RR=1.17;95%CI:1.01-1.34) and H.pylori infection (RR=2.35;95%CI:1.24-4.46).CONCLUSION:Pre-existing diabetes mellitus may increase the risk of gastric cancer by approximately 19%.This effect seems to be unrelated to geographical region.

Thymidylate synthase genetic polymorphisms and cancer risk： a meta-analysis of 37 case-control studies

Background Several studies have evaluated the association between polymorphisms of thymidylate synthase （TS） and cancer risk in diverse populations but with conflicting results. By pooling the relatively small samples in each study, it is possible to evaluate the association using a meta-analysis. Methods A comprehensive search was conducted to identify all case-control studies on TS on a 28-bp tandem repeats in 5＇untranslated region （5UTR） and a 6-bp insertion （ins） and deletion （del） mutation in 3＇UTR of the gene and cancer risk. Meta-analysis was conducted using a fixed and random effect model. Results Our meta-analysis on a total of 13307 cancer cases and 18226 control subjects from 37 published case-control studies showed no significant association between the risk of cancer and the 5＇UTR 28-bp tandem repeats polymorphism （3R/3R vs. 2R/2R： 0R=1.06, 95% CI, 0.93-1.20） or the 3＇UTR 6-bp ins/del polymorphism （del6/del6 vs. ins6/ins6： OR=0.93, 95% CI, 0.81-1.08） with significant between-study heterogeneity. In the cancer type- and ethnic subgroup-stratification analyses, we did not find any association between TS polymorphisms and cancer risk either. Conclusion TS 5＇UTR 28-bp tandem repeats and 3＇UTR 6-bp ins/del polymorphisms may not be associated with cancer risk.

The risks, degree of malignancy and clinical progression of prostate cancer associated with the MDM2 T309G polymorphism： a meta-analysis

To determine the risk, malignant degree and clinical progression of prostate cancer （PCa） associated with mouse double-minute 2 protein （MDM2） T309G variants, a meta-analysis was performed on all eligible published studies. Odds ratios （ORs） with 95% confidence intervals （CIs） were estimated to assess these associations in seven studies that included 5151 cases and 1003 controls. In the overall analysis, the 309G allele was significantly associated with a decreased PCa risk （0R=0.85, 95% CI： 0.74-0.97）; this was also the case for the homozygous comparison （0R--0.72, 95% Ch 0.55-0.95） and the dominant genetic model （0R=0.79, 95% Ch 0.65-0.96）. The 309G allele was also found to be significantly associated with lower degrees of PCa malignancy （0R=0.85, 95% Ch 0.75-0.96） in the overall analysis, as well as in the heterozygous comparison （0R=0.79, 95% Ch 0.65-0.96）, homozygous comparison （0R=0.76, 95% Ch 0.58-0.98） and dominant genetic model （0R=0.81, 95% CI： 0.68-0.96）. Furthermore, grouping analysis showed that the 309G allele in Caucasians was significantly correlated with a decreased PCa risk （0R=0.77, 95% Ch 0.61-0.96）; this was also the case in the homozygous comparison （0R=0.51, 95% Ch 0.31-0.86）. The grouping analysis also showed that the 309G variant in Caucasians was significantly associated with a lower degree of PCa malignancy in all of the genetic models. In addition, we found that the 309G variant in Caucasians was significantly associated with a slower PCa clinical progression in all of the genetic models. In summary, our meta-analysis showed that the MDM2 309G variant was significantly associated with a decreased PCa risk, lower malignant degree and slower clinical progression in Caucasians, but there was no obvious association in the Asian population.

Can statins reduce risk of lung cancer,especially among elderly people? A meta-analysis

Objective： As the most common cause of cancer mortality throughout the world, lung cancer has drawn people＇s attention on how to reduce the risk with chemopreventive ways. Many epidemiological studies have shown inconsistent effects of statins on lung cancer, but some observational studies have showed that statins had protective effect on lung cancer among elderly people. So we preformed this meta-analysis to find whether statins were chemopreventive. Methods： We searched MEDLINE, EMBASE and Web of Science databases from inception to September, 2013. A total of 23 studies were selected, including 15 observational studies and 8 randomized controlled trials （RCTs）. Both fixed and random-effects models were used to calculate pooled estimates in primary and sensitivity analyses. We used Q and 12 statistics to assess statistical heterogeneity, and evaluated publication bias by Begg＇s test and Egger＇s test. Results： No association between statins and lung cancer risk was identified either in the meta-analysis among RCTs [relative risk （RR）： 0.95, 95% confidence interval （95% CI）： 0.85-1.06] or observational studies （RR： 0.89, 95% CI： 0.77-1.04）. We also selected 6 observational studies that all researched on elderly people. The result of meta-analysis showed that there was still no protective effect between statins and lung cancer among elderly people （RR： 1.03, 95% CI： 0.96-1.11）. Conclusions： Our results did not support a protective effect of statins on the overall lung cancer risk and the lung cancer risk among elderly people. More well-designed RCTs are needed to enhance our understanding of the chemopreventive effect of statins on lung cancer.

Statin use and risk of liver cancer: A meta-analysis of 7 studies involving more than 4.7 million patients

AIM： To pool data currently available to determine the association between statin use and the risk of liver cancer.METHODS： A computerized literature search was conducted to identify those relevant studies between Janu-ary 1966 and March 2013. Stata 11.0 （Stata Corp, College Station, Texas） was used for statistical analyses. Pooled relative risk （RR） estimates with 95%CI were calculated for overall analysis and subgroup analyses, using the random- and fxed-effects models. Heteroge-neities between studies were evaluated by Cochran’s Q test and I^2 statistic. The Begg’s funnel plot and Egger’s regression asymmetry test were used to detect the publication bias.RESULTS： Seven studies were included in our meta-analysis according to the selection criteria, including four cohort studies and three case-control studies. These studies involved 4725593 people and 9785 liver cancer cases. The overall analysis showed that statin use was statistically associated with a signifcantly reduced risk of liver cancer （random-effects model, RR=0.61, 95%CI： 0.49-0.76, P 〈 0.001; fxed-effects mod-el, RR=0.64, 95%CI： 0.57-0.71, P 〈 0.001）; however, significant heterogeneity was found between studies （Cochran’s Q statistic=19.13, P=0.004; I^2 = 68.6%）. All subgroup analyses provided supporting evidence for the results of overall analysis. Begg’s （Z=0.15, P=0.881） and Egger’s test （ t=-0.44, P=0.681） showed no signifcant risk of having a publication bias.CONCLUSION： Statin use was associated with the reduced risk of liver cancer. To clearly clarify this relationship, more high quality studies are required.

Older age at first birth is a risk factor for pancreatic cancer： a meta-analysis

BACKGROUND： Some studies found that age at first birth is associated with pancreatic cancer; others did not. The present meta-analysis was to evaluate the relationship between age at first birth and pancreatic cancer in women.DATA SOURCES： We searched Pub Med, Embase, and the Cochrane Library for relevant publications on age at first birth and pancreatic cancer up to April, 2014. The eligible studies（six cohorts and five case-controls） were independently selected by two authors. Pooled relative risk（RR） estimates and corresponding 95% confidence interval（95% CI） were calculated using the inverse-variance method.RESULTS： The pooled RR of pancreatic cancer risk for the highest versus lowest categories of age at first birth was 1.21（95% CI： 1.01-1.45, P=0.314, I^2=13.7%）. Consistent relationships were also observed within subgroup analyses stratified by study design, geographic region, and whether the studies included adjustment for cigarette smoking, diabetes, or all of the confounders. In this meta-analysis, no publication bias among studies was observed using Egger＇s test（P=0.383） or Begg＇s test（P=0.436）.CONCLUSION： Our findings suggest that older age at first birth is associated with an increased risk of pancreatic cancer in women and the exact functional mechanism needs further investigation.

绿茶与口腔癌发病风险的Meta分析

目的:系统评价绿茶与口腔癌发病风险的关系。方法:计算机检索中国期刊全文数据库、万方数据库、维普数据库、中国生物医学文献数据库、The Cochrane Library、PubMed、Web of Science、Embase数据库,检索时限为建库至2023年4月30日,采用RevMan5.4进行Meta分析。结果:共纳入12篇文献,样本量(病例/对照)共有4 259/45 141人。Meta分析结果显示,绿茶摄入是口腔癌发生的保护性因素[OR=0.86,95%CI=(0.78,0.94),P=0.002];摄入量≥500 mL [OR=0.67,95%CI=(0.56,0.80),P<0.000 1]、年限≥20年[OR=0.56,95%CI=(0.42,0.77),P=0.000 3]、浓度适中[OR=0.58,95%CI=(0.48,0.69),P<0.000 01]、温茶[OR=0.40,95%CI=(0.29,0.53),P<0.000 01]是口腔癌发生的保护因素;牛奶与绿茶的饮用呈协同保护作用[OR=0.44,95%CI=(0.35,0.56),P<0.000 01]。结论:绿茶摄入是口腔癌发生的保护因素;牛奶的饮用可与绿茶呈协同作用;建议坚持长期饮茶,每天绿茶摄入量≥500 mL,注意浓度、温度适宜。

中国人群食管癌主要危险因素Meta分析

目的探讨中国人群食管癌发病的危险因素。方法通过检索2000年~2022年中国知网、维普、万方等数据库中公开发表的文献,收集关于食管癌危险因素的文献,荟萃分析使用Stata 17.0软件完成,合并比值比(OR)及其95%CI。通过Q检验和I2统计量进行异质性检测,采用随机效应模型合并OR值。文献发表偏倚的检测使用Egger检验和Begg检验,进一步使用剪补法检验未发表文献对荟萃分析结果是否造成显著影响。结果本研究共纳入38项研究,病例组样本量共计8518例,对照组样本量共计12940例。饮酒、吸烟、食管癌家族史、喜食油炸食品、喜食腌制食品、喜食辛辣食品、喜食坚硬食物、喜热烫饮食、进食速度快、饮食不规律、喜食霉制食物、高盐饮食、食管病变、胃肠炎、精神刺激、性格内向、体质量指数(BMI)<18.5 kg·m^(-2)、低收入、饮用非自来水共19个危险因素合并OR值及95%CI均>1。喜食葱蒜、喜食豆制品、文化程度高、喜食水果、喜食蔬菜合并OR值及其95%CI均<1。饮茶、喜食鲜肉、喜食禽蛋的合并OR值无统计学意义。敏感性分析和发表偏倚的检测结果表明本研究受发表偏倚影响较小,结果较为稳定、可靠。结论食管癌的发生影响因素是多方面的,与环境、饮食及遗传因素息息相关。

肝癌患者营养不良危险因素的Meta分析

目的:系统综述肝癌患者营养不良的危险因素,为防治肝癌患者的营养不良提供参考依据。方法:采用Meta分析方法,计算机检索中国知网(CNKI)、万方数据知识服务平台、维普中文期刊服务平台、PubMed、Cochrane Library、EmBase数据库,查找肝癌患者发生营养不良危险因素的病例对照研究相关文献,检索时间为从建库至2022年4月,对文献质量进行评价,采用RevMan 5.4软件进行数据分析。结果:共纳入研究文献13篇,其中英文1篇、中文12篇,共纳入2 353例患者。Meta分析结果显示,年龄、BMI、肝癌TNM分期、Child-pugh分级、贫血、血清白蛋白、血清前白蛋白是肝癌患者发生营养不良的危险因素(P<0.05);性别、婚姻状况、是否伴有乙型肝炎、谷丙转氨酶、谷草转氨酶等因素无显著统计学意义(P>0.05)。结论:肝癌患者发生营养不良危险因素较多,其中年龄、BMI、肝癌TNM分期、Child-pugh分级、贫血、血清白蛋白、血清前白蛋白7项为肝癌患者发生营养不良的主要危险因素。

乳腺癌植入式静脉输液港患者导管相关性血栓形成危险因素的Meta分析

目的 分析乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素,为避免发生导管相关性血栓提供参考。方法 计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于乳腺癌植入式静脉输液港患者导管相关性血栓形成危险因素的病例对照研究和队列研究,检索时限为建库至2024年1月,采用RevMan5.3软件进行Meta分析。结果 共纳入19篇文献,9938例乳腺癌患者。年龄≥60岁(OR=0.44,P=0.005)、体质量指数>24 kg/m2(OR=1.85,P=0.001)、硅胶导管材质(OR=0.75,P=0.040)、左侧置管(OR=1.23,P=0.040)、上臂输液港植入(OR=0.23,P=0.010)、蒽环类与紫杉类联合化疗方案(OR=1.95,P=0.030)、肿瘤临床分期Ⅲ~Ⅳ期(OR=0.53,P<0.001)、静脉血栓史(OR=3.24,P=0.030)、高凝状态(OR=2.43,P<0.001)、高血压史(OR=1.84,P=0.001)是乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素。结论 医护人员应加强高危乳腺癌患者的管理,针对上述危险因素提前采取措施,以降低导管相关性血栓的发生率,提高其生活质量。

cN0级单侧甲状腺乳头状癌患者对侧气管旁淋巴结转移临床特征的Meta分析

目的分析临床淋巴结阴性(clinically node-negative,cN0)的单侧甲状腺乳头状癌(papillary thyroid cancer,PTC)患者发生对侧中央区淋巴结转移(contralateral central lymph node metastasis,CCLNM)临床危险因素,为预防性中央区淋巴结清扫(prophylactic central lymph node dissection,PCLND)的范围提供依据。方法检索PubMed、Cochrane Library、Web of Science、EMBASE、CNKI数据库中公开发表研究cN0单侧PTC患者CCLNM临床特征的相关文献,截至时间为2023年9月,采用RevMan5.4、Stata15.1软件进行数据分析。结果共纳入14篇文献,包括3532例患者。所有患者CCLNM发生率范围为3.9%~30.6%。分析结果提示:男性(OR=1.65,95%CI=1.28~2.11)、肿瘤直径≥1 cm(OR=2.88,95%CI=2.30~3.60)、年龄≤55岁(OR=2.10,95%CI=1.15~3.82)、包膜受累(OR=1.63,95%CI=1.04~2.57)、腺外侵犯(OR=1.76,95%CI=1.31~2.36)、脉管侵犯(OR=4.23,95%CI=2.25~7.98)、同侧中央区淋巴结转移(OR=10.83,95%CI=5.56~21.10)、喉前淋巴结转移(OR=4.32,95%CI=2.66~7.02)、气管前淋巴结转移(OR=6.67,95%CI=2.06~21.54)患者更容易发生CCLNM(P均<0.05)。而未发现肿瘤多灶性、桥本甲状腺炎、BRAF基因突变、MACIS≥6、超声回声、超声血流与CCLNM相关。结论男性、肿瘤直径≥1 cm、年龄≤55岁、包膜受累、腺外侵犯、脉管侵犯、同侧中央区淋巴结转移、喉前淋巴结转移、气管前淋巴结转移是发生CCLNM的重要危险因素,这些因素可作为cN0单侧PTC患者PCLND的程度指标。

原发性肝癌与中医体质相关性的Meta分析

目的系统评价原发性肝癌患者中医9种体质分布情况,初步明确该病常见的高危体质类型,为中医药防治原发性肝癌提供循证医学证据。方法检索知网、万方、维普、PubMed、Web of science建库至2024年7月1日所有评价原发性肝癌与中医体质类型相关性的临床研究文献,以系统评价方法对检索文献进行筛选、质量评价及资料整合,对最终纳入的文献采用Stata17软件进行荟萃分析。结果共纳入8项研究的1370例患者,Meta分析提示原发性肝癌患者各中医体质类型的比例及95%置信区间依次为平和质21.3%(15.5%~27.8%)、瘀血质14.9%(7.6%~24%)、阳虚质14.2%(7.9%~22%)、气虚质13.7%(9.1%~19%)、湿热质12.7%(9.2%~16.6%)、痰湿质7.5%(4.3%~11.4%)、气郁质5.2%(3.2%~7.6%)、阴虚质4.8%(1.6%~9.3%)、特禀质2%(0.7%~3.9%)。结论瘀血质、阳虚质、气虚质、湿热质是原发性肝癌患者的主要体质类型,可能是原发性肝癌发生的高危因素。

肝癌TACE术后复发危险因素的Meta分析

目的 系统评价肝癌经动脉化疗栓塞术(transcatheter arterial chemoembolization, TACE)后影响复发的危险因素,为预防TACE术后复发提供科学依据。方法 检索PubMed、EmBase、Cochrane Library、Web of Science、中国知网、万方数据库、维普、中国生物医学文献数据库自建库至2023年2月1日发表的有关肝癌TACE术后复发危险因素的文献报道。由2名研究者根据纳入和排除标准进行文献筛选、数据提取和质量评价。使用软件Rev Man 5.3对纳入文献进行Meta分析和发表偏倚评估。结果 通过筛选最终共纳入9篇高质量队列研究进行Meta分析。分析结果显示差异有统计学意义的危险因素包括甲胎蛋白(OR=3.05,95%CI:1.11~8.38,P=0.03)、白蛋白(OR=5.79,95%CI:2.46~13.62,P<0.0001)、肿瘤分化程度(OR=2.64,95%CI:1.00~6.92,P=0.05)、肿瘤数量(OR=3.76,95%CI:1.71~8.27,P=0.001)、肿瘤ADC值(OR=0.01,95%CI:0.00~0.09,P<0.0001)。结论 肿瘤直径、甲胎蛋白、白蛋白、肿瘤分化程度、肿瘤数量和肿瘤ADC值是TACE术后复发的危险因素。