Is diabetes mellitus associated with increased incidence and disease-specific mortality in endometrial cancer? A systematic review and meta-analysis of cohort studies.
Is diabetes mellitus associated with increased incidence and disease-specific mortality in endometrial cancer? A systematic review and meta-analysis of cohort studies.
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糖尿病与子宫内膜癌的发病率和疾病特异性死亡率增加有关吗？队列研究的系统回顾和荟萃分析。
DOI：
10.1016/j.ygyno.2014.07.095
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发表时间：
2014-10
影响因子：
4.7
通讯作者：
Zeidan AM
中科院分区：
文献类型：
--
作者：
Liao C;Zhang D;Mungo C;Tompkins DA;Zeidan AM
评估糖尿病（DM）与子宫内膜癌（EC）发病率和疾病特异性死亡率之间的关系。检索MEDLINE、EMBASE和2011-2013年妇科肿瘤学会年会的会议摘要，以获得原始队列研究的报告，这些研究招募了基线时无EC的糖尿病和非糖尿病女性，以按DM状态比较EC的发生率和疾病特异性死亡率。对纳入的报告进行了研究人群的人口统计学特征、研究设计、效应测量和偏倚风险检查。采用科克伦Q统计量在0.05显著性水平和I2统计量的卡方检验评价统计异质性。发表偏倚通过漏斗图的视觉检查和Egger检验进行评估。29项队列研究（17项前瞻性研究，12项回顾性研究）符合本次审查的条件，其中23项报告了EC发生率，5项报告了疾病特异性死亡率，1项报告了两者。糖尿病女性与非糖尿病女性的EC发生率的总体相对危险度（RR）为1.89（95%CI，1.46-2.45; p < 0.001），总体发生率比值为1.61（95%CI，1.51-1.71; p < 0.001）。疾病特异性死亡率的合并RR为1.32（95%CI，1.10-1.60; p = 0.003），而报告标准化死亡率比的研究结果不一致。在纳入的研究中，仍存在大量的临床和方法学异质性;此外，事件EC的风险比显示出显著的统计异质性，因此未进行定量合成。有一致的证据表明，糖尿病与EC事件风险增加之间存在独立关联，而糖尿病与EC特异性死亡率之间的关联仍不确定。更好地考虑选择偏倚、信息偏倚和混杂因素的进一步研究将进一步促进涉及DM和EC的因果推断。
To assess the association between diabetes mellitus (DM) and the incidence and disease-specific mortality of endometrial cancer (EC). MEDLINE, EMBASE and conference abstracts of the 2011–2013 Annual Meetings of Society of Gynecological Oncology were searched for reports of original cohort studies that enrolled diabetic and non-diabetic women who were free of EC at baseline to compare the incidence and disease-specific mortality of EC by DM status. The included reports were examined for demographic characteristics of study populations, study design, effect measures and risk of bias. Statistical heterogeneity was evaluated with Chi-square test of the Cochrane Q statistics at the 0.05 significance level and I2 statistic. Publication bias was assessed by visual examination of a funnel plot and the Egger’s test for small-study effects. Twenty-nine cohort studies (17 prospective, 12 retrospective) were eligible for this review, 23 of which reported EC incidence, five reported disease-specific mortality and one reported both. For incidence of EC among women with versus without DM, the summary relative risk (RR) was 1.89 (95%CI, 1.46–2.45; p < 0.001) and the summary incidence rate ratio was 1.61 (95%CI, 1.51–1.71; p < 0.001). The pooled RR of disease-specific mortality was 1.32 (95%CI, 1.10–1.60; p = 0.003), while results in the studies reporting standardized mortality ratios were inconsistent. There remains considerable amount of clinical and methodological heterogeneity among the included studies; moreover, the hazard ratios for incident EC showed significant statistical heterogeneity and therefore were not quantitatively synthesized. There is consistent evidence for an independent association between DM and an increased risk of incident EC, while the association between DM and EC-specific mortality remains uncertain. Further studies with better considerations for selection bias, information bias and confounding will further facilitate causal inference involving DM and EC.
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DOI：
10.1634/theoncologist.2009-0300
发表时间：
2010
期刊：
The oncologist
影响因子：
--
作者：
Hemminki K;Li X;Sundquist J;Sundquist K
通讯作者：
Sundquist K
影响因子：
8.2
作者：
Friberg, E.;Orsini, N.;Wolk, A.
通讯作者：
Wolk, A.
影响因子：
5
作者：
Coughlin, SS;Calle, EE;Thun, MJ
通讯作者：
Thun, MJ
影响因子：
8.2
作者：
Geier, A. S.;Wellmann, J.;Hense, H. W.
通讯作者：
Hense, H. W.
影响因子：
8.8
作者：
Burbos, N.;Musonda, P.;Nieto, J. J.
通讯作者：
Nieto, J. J.