叶酸水平与食管癌关系的Meta分析  

Meta-analysis on the relationship between folate levels and esophageal cancer

作　　者：尹钰[1] 帕力达.托了汗 陈艳[1,3] 

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830011 [2]新疆塔城地区托里县妇幼保健医院,新疆托里834500 [3]新疆食管癌研究所,乌鲁木齐830011

出　　处：《新疆医科大学学报》2015年第6期748-753,共6页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2014211C002)

摘　　要：目的应用Meta分析评价叶酸水平与食管癌的相关性。方法检索中国期刊全文数据库（CNKI）、万方生物医学期刊数据库、维普中文科技期刊数据库（VIP）、Pub Med等数据库,收集2005-2014年国内外公开发表的关于叶酸水平与食管癌的相关性研究的文献。将所纳入的文献按食管癌病理类型不同、叶酸来源不同、实验人群所处地域不同进行分组,应用Review Manager5.3软件进行统计学分析,效应量为比值比（OR）,并计算95%可信区间（95%CI）,检验异质性,根据异质性检验结果选择应用固定效应模型或随机效应模型进行分析处理。结果本研究最终纳入13篇相关文献,病例组共2 830人,对照组共8 690人。Meta分析结果显示,各研究间存在统计学异质性,采用随机效应模型进行描述,病例组与对照组叶酸水平的差异有统计学意义（OR=0.51,95%CI：0.37~0.69,Z=4.26,P〈0.000 1）。亚组分析显示,叶酸水平与食管鳞癌（ESCC）的发生有关系（P=0.005）;膳食叶酸摄入水平及血清叶酸水平均与食管癌的发生有关系（膳食叶酸：P=0.004,血清叶酸：P〈0.0001）;亚洲人群的叶酸水平与食管癌的发生有关系（P〈0.000 01）,但在非亚洲人群的研究中尚不能表明叶酸水平与食管癌的发生有关系（P=0.05）。结论叶酸水平与食管癌发病风险呈负相关,叶酸为食管癌发生的保护因素。Objective A Meta-analysis was used to evaluate the relationship between folate levels and esoph- ageal cancer. Methods CNKI, Wanfang Data, VIP, Pubmed databases were searched for studies published from 2005 to 2014 on the association between folate levels and esophageal cancer. The Review Manager 5.3 software was used for meta-analysis. Results were described as odds ratios （OR） with 95% confidence intervals （CI）. According to the result of the heterogeneity test, the fixed effect model or ran- dom effect model was used for merge analysis. Results A total of 13 case-control studies involving 2 830 cases and 8 690 controls were included in the meta-analysis. Meta-analysis showed that there was significant heterogeneity between studies, folate levels was inversely associated with esophageal cancer risk （OR = 0.51,95 % CI ： 0.37 ~ 0.69, Z =4.26, P 〈0.000 1）. Subgroup analysis showed that folate levels was negatively correlated with esophageal squamous cell carcinoma （ESCC） （P =0.005） ; Similarly dietary fo- late intake levels and serum folate levels were negatively correlated with esophageal cancer （dietary folate： P =0.004, serum folate （P 〈0.000 1）; In the Asian group, there was negative correlation between the risk of esophageal cancer and folate levels （P 〈0.000 01）, however such a correlation was not found in non-Asian group （P =0.05）. Conclusion The current meta-analysis demonstrates that the folate levels is inversely associated with esophageal cancer risk, folic acid is a protective factor for esophageal cancer.

关 键 词：叶酸 食管癌 META分析 

分 类 号：R735.1[医药卫生—肿瘤]