Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON).
Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON).
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DOI：
10.1371/journal.pone.0103508
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Vaughan TL
中科院分区：
文献类型：
--
作者：
Cook MB;Corley DA;Murray LJ;Liao LM;Kamangar F;Ye W;Gammon MD;Risch HA;Casson AG;Freedman ND;Chow WH;Wu AH;Bernstein L;Nyrén O;Pandeya N;Whiteman DC;Vaughan TL
先前的研究已经证明胃食管反流和食管腺癌（EA）之间的关联。目前尚不清楚这些关联在多大程度上因人口、年龄、性别、体重指数和吸烟而异，或者症状的持续时间和频率是否在预测风险方面相互作用。Barrett和食管腺癌联盟（BEACON）允许对这些问题进行深入评估。关于烧心和反流症状和协变量的详细信息可从EA和食管胃结合部腺癌（EGJA）的5项BEACON病例对照研究中获得。我们进行了单研究多变量逻辑回归，然后进行随机效应荟萃分析。还进行了分层分析、荟萃回归和敏感性分析。五项研究提供了1，128例EA病例，1，229例EGJA病例和4，057例对照进行分析。所有汇总估计值均表明胃灼热/反流症状与EA之间存在显著正相关。烧心持续时间增加与EA风险增加相关;症状持续时间<10年、10至<20年和≥20年的优势比分别为2.80、3.85和6.24。与EGJA的相关性较弱，但对于那些接触最高的人来说仍然具有统计学意义。烧心/反流症状的频率和持续时间与较高的风险独立相关。当按年龄、性别、吸烟和体重指数分层时，我们观察到相似的关联强度。该分析表明，烧心/反流症状与EA之间的相关性很强，随着持续时间和/或频率的增加而增加，并且在主要风险因素中一致。EGJA的相关性较弱表明该癌症部位具有不同的发病机制或代表了混合的患者人群。
Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA). It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON) allowed an in-depth assessment of these issues. Detailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA). We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted. Five studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ≥20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index. This analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients.
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影响因子：
3.8
作者：
Jansson, C;Johansson, ALV;Lagergren, J
通讯作者：
Lagergren, J
影响因子：
24.5
作者：
Bredenoord, AJ;Weusten, BLAM;Smout, AJPM
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Smout, AJPM
影响因子：
24.5
作者：
Whiteman, D. C.;Sadeghi, S.;Green, A. C.
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Green, A. C.
影响因子：
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作者：
Gammon, MD;Schoenberg, JB;Fraumeni, JF
通讯作者：
Fraumeni, JF
影响因子：
2.3
作者：
BROWN, LM;SILVERMAN, DT;HOOVER, RN
通讯作者：
HOOVER, RN