散发性十二指肠肿瘤与结直肠肿瘤相关性Meta分析  

Meta analysis on correlation between sporadic duodenal neoplasm and colorectal neoplasm

作　　者：王程瑶 张政[1] 吴静[1] Wang Chengyao;Zhang Zheng;Wu Jing(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院消化内科,北京100050

出　　处：《临床荟萃》2022年第7期581-590,共10页Clinical Focus

基　　金：北京市科技计划课题--结直肠癌早期诊断评分系统的建立及其新型分子标志物的探索(Z211100002921028);首都卫生发展科研专项--基于血浆细胞因子的异时性站直肠腺瘤发生风险预测模型的建立及验证(首发2022-2-2025);首都卫生发展科研专项(2020-4-2085);北京市医院管理局医学协同发展中心专项经费资助项目(XXZ0105);导师专项科研基金(YYDSZX201901)。

摘　　要：目的采用Meta分析方法对已发表的有关散发性十二指肠肿瘤(SDN)与结直肠肿瘤(CRN)(主要包括结直肠腺瘤、结直肠癌)的研究进行综合评价。方法对符合纳入标准的15篇文献(14篇病例对照研究+1篇横断面研究)使用Review Manager5.3软件进行Meta分析。选择OR值及95%CI作为Meta分析指标,并做出倒漏斗图,对各研究结果进行异质性检验和效应值合并计算。结果纳入总样本量为205959例,其中病例组1286例,对照组204673例。通过Meta分析对各研究进行合并后,认为结果存在中度异质性(I^(2)=44%,P=0.03),亚组分析结果显示SDN发生部位可能是各研究间异质性的潜在来源。根据发生的结局不同进行分组,结果显示SDN增加了各阶段CRN的发病风险(结直肠腺瘤OR=2.29,95%CI=1.74-3.02;结直肠癌OR=2.87,95%CI=1.96-4.02;进展期腺瘤OR=2.83,95%CI=2.27-3.53;进展期肿瘤OR=3.60,95%CI=2.14-6.07)。根据发生CRN部位及数目不同进行分组,结果显示位于左半结肠、多发的肿瘤和SDN之间具有一定相关性(OR=1.37,95%CI=1.16-1.62;OR=9.30,95%CI=1.41-61.44)。结论SDN患者发生各种类型CRN的风险均会增加,特别是与进展期、位于左半结肠、多发的CRN病变之间具有更显著的相关性。Objective Metaanalysis was applied to comprehensively review published studies on sporadic duodenal neoplasm(SDN)and colorectal neoplasm(CRN,mainly including colorectal adenoma and colorectal cancer).Methods Fifteen documents(14 casecontrol studies+1 crosssectional study)satisfying the inclusion criteria were subject to meta analysis with Review Manager 5.3 software,OR value and 95%CI were selected as metaanalysis indicators,and inverted funnel plot was developed to test the heterogeneity of results and calculate combined effect values.Results A total sample size of 205959 including 1286 cases in the case group and 204673 cases in the control group were included.Moderate heterogeneity(I^(2)=44%,P=0.03)was considered in the results of casecontrol studies through metaanalysis,and subgroup analysis showed that the site of SDN occurrence may be a potential source of heterogeneity in studies.The results of grouping according to different outcomes showed that SDN increased the onset risk of CRN at all stages(colorectal adenoma OR=2.29,95%CI=1.74-3.02;colorectal cancer OR=2.87,95%CI=1.96-4.02;advanced adenoma OR=2.83,95%CI=2.27-3.53;advanced neoplasm OR=3.60,95%CI=2.14-6.07).The grouping was made according to the different sites and number of CRN,the results showed that multiple tumors in left colon was certainly related to SDN(OR=1.37,95%CI=1.16-1.62;OR=9.30,95%CI=1.41-61.44).Conclusion The risks of various CRN in SDN patients will increase,especially,it is more significantly correlated with advanced and multiple CRN lesions located in the left colon.

关 键 词：十二指肠肿瘤 结直肠肿瘤 META分析 

分 类 号：R735.31[医药卫生—肿瘤]