饮水砷暴露与肿瘤相关性的Meta分析  

Association of arsenic exposure through drinking water and tumor： a meta-analysis

作　　者：周睛 席淑华 

机构地区：[1]中国医科大学公共卫生学院地球化学性疾病研究室,沈阳110122

出　　处：《中华地方病学杂志》2018年第2期155-158,共4页Chinese Journal of Endemiology

基　　金：国家自然科学基金（81673207）

摘　　要：目的系统评价饮水砷暴露与人类癌症风险之间的关系。方法计算机检索中国学术期刊网（CNKI）、维普中文期刊服务平台（VIP）、万方全文数据库（WanFangData）、中国生物医学文献数据库（CMB）、PubMed、Embase和CochraneLibrary等数据库，查找国内外关于饮水砷暴露与肿瘤发生相关的研究，检索时限为1997年1月1日至2017年1月1日。采用RevMfill5．3软件进行Meta分析，将符合纳入标准的文献进行异质性检验，应用固定效应模型或随机效应模型进行综合定量分析，计算合并比值比（OR值）及95％可信区间（CI），利用倒漏斗图定性评价发表偏倚。并进行敏感性分析。结果最终纳入14个研究，砷暴露组纳入13927人，对照组5720人。Meta分析结果显示，纳入的14个研究存在较好的同质性，采用固定效应模型进行分析，合并OR及95％CI=1．20（1．09，1．33），即砷暴露组发生肿瘤的危险是非暴露组的1．20倍。倒漏斗图左右基本对称，文献发表偏倚较小；敏感性分析，结果较可靠。结论饮水砷暴露可能是肿瘤发生的危险因素。Objective To systematically review the relationship between arsenic exposure through drinking water and human cancer risk. Methods China National Knowledge Infrastructure （CNKI）, VIP Database, WanFang Data, China Biology Medicine Disc （CBM）, PubMed, Embase and Cochrane Library were searched through computer to find out the relationship between arsenic exposure and tumorigenesis. The search period was from January 1, 1997 to January 1, 2017. Meta-analysis was performed using RevMan 5.3. The heterogeneity of the literatures that met the inclusion criteria was examined, and analysis was performed by using fixed effect model or random effect model. OR and 95%CI were calculated, the publication bias was evaluated by inverted funnel plot, and sensitivity analysis was performed. Results Totally 14 literatures entered into this study, 13 927 people in arsenic exposure group, 5 720 people in control group. The meta-analysis showed that, 14 literatures were homogeneous through the heterogeneity test, and was analyzed in the fixed effect model with OR （95%CI） = 1.20 （1.09, 1.33）, which suggested that the risk of cancer in the arsenic exposure group was 1.20 times higher than that in control group. Inverted funnel plot was basically symmetrical, literatures publication bias was small; the result was more reliable by sensitivity analysis. Conclusion Arsenic exposure through drinking water may be a risk factor of tumor.

关 键 词：砷中毒 饮水 肿瘤 META分析 

分 类 号：R195.1[医药卫生—卫生统计学]