Atopy and risk of brain tumors: A meta-analysis
Atopy and risk of brain tumors: A meta-analysis
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DOI：
10.1093/jnci/djm170
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发表时间：
2007-10-17
影响因子：
10.3
通讯作者：
Michaud, Dominique
中科院分区：
文献类型：
--
作者：
Linos, Eleni;Raine, Tim;Michaud, Dominique
背景胶质瘤是一种进展迅速的疾病，对其病因知之甚少。特应性疾病在西方人群中呈上升趋势，人们对其长期健康后果的兴趣与日俱增。特应性和神经胶质瘤的风险之间存在负相关关系。我们对特应性疾病与胶质瘤和脑膜瘤风险之间的关系进行了荟萃分析。方法在1979年至2007年2月的MEDLINE、ISI Web of Science和EMBASE数据库的电子文献搜索中，我们确定了病例对照和队列研究，量化了哮喘、湿疹、花粉热或过敏病史与经医学证实的胶质瘤或脑膜瘤的诊断之间的关系。我们根据这些研究的方差的倒数进行荟萃分析。结果共纳入8项观察性研究，包括3450例胶质瘤患者和1070例脑膜瘤患者。特应性疾病病史与神经胶质瘤的风险呈负相关。有特应性病史者与无特应性病史者患胶质瘤的合并相对危险度(RR)分别为过敏0.61(95%CI=0.55~0.67)、哮喘0.68(95%CI=0.58~0.80)、湿疹0.69(95%CI=0.58~0.82)。代理报告不太可能解释这种联系，因为没有代理报告的研究的汇总相对风险估计仍然是相反的，并且具有统计学意义(FIR=0.66，95%CI=0.58至0.75)。发表偏差也不太可能是反向关联的解释，因为这种关联在敏感性分析中持续存在，而且漏斗图是对称的。虽然关于特应性疾病和脑膜瘤的信息是有限的和异质性的，但总体上没有发现特应性疾病和脑膜瘤之间有统计学意义的相关性。结论我们观察到特应性疾病和胶质瘤之间存在很强的负相关，这不太可能仅用方法学偏差来解释。
Background Glioma is a rapidly progressive disease, and little is known about its etiology. Atopic diseases are on the rise in western populations, with increasing interest on their long-term health consequences. An inverse association between atopy and the risk of glioma has been observed. We carried out a meta-analysis of studies examining the association between atopic disease and risk of glioma and meningioma.Methods In an electronic literature search of the MEDLINE, ISI Web of Science, and EMBASE databases from 1979 through February 2007, we identified case-control and cohort studies quantifying associations between a history of asthma, eczema, or hay fever or allergy and a medically confirmed diagnosis of glioma or meningioma. We performed meta-analysis by pooling studies according to the inverse of their variances. We evaluated publication bias using funnel plot and sensitivity analyses.Results A total of eight observational studies were included, with a total of 3450 patients diagnosed with glioma and 1070 patients with meningioma. A history of atopic disease was inversely related to risk of glioma. The pooled relative risks (RRs) of glioma comparing those with a history of an atopic condition with those with no history of that condition were 0.61 (95% confidence interval [Cl] = 0.55 to 0.67) for allergy, 0.68 (95% Cl = 0.58 to 0.80) for asthma, and 0.69 (95% Cl = 0.58 to 0.82) for eczema. Proxy reporting was unlikely to explain the association because the pooled relative risk estimate from studies without proxy reporting remained inverse and statistically significant (FIR = 0.66, 95% Cl = 0.58 to 0.75). Publication bias was also an unlikely explanation for the inverse association because the association persisted in a sensitivity analysis and the funnel plot was symmetric. No overall statistically significant association was noted for atopy and meningioma, although the information on this disease was limited and heterogeneous.Conclusions We observed a strong inverse relationship between atopic disease and glioma that is unlikely to be explained by methodologic bias alone.