Adiposity and cancer survival: a systematic review and meta-analysis.
Adiposity and cancer survival: a systematic review and meta-analysis.
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DOI：
10.1007/s10552-022-01613-7
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发表时间：
2022-10
期刊：
影响因子：
--
通讯作者：
Caan BJ
中科院分区：
文献类型：
--
作者：
Cheng E;Kirley J;Cespedes Feliciano EM;Caan BJ
直接量化脂肪组织的临床成像测试（尤其是 CT 和 MRI）的可用性不断增加，导致检查内脏、皮下和整体脂肪与癌症生存之间关系的研究迅速增加。为了总结这一新兴文献，我们对多种癌症类型中脂肪组织分布和癌症生存的影像测量和人体测量指标进行了系统回顾和荟萃分析。使用与肥胖、癌症和生存相关的关键词，我们对 PubMed 和 MEDLINE、Embase 和 Web of Science 核心合集数据库中从数据库建立到 2021 年 6 月 30 日的文献进行了系统检索。我们使用随机效应方法来计算每种癌症类型内的汇总风险比 (HR) 和相应的 95% 置信区间 (CI)，并使用 Cochran’s Q 检验和 I2 检验来测试异质性。我们纳入了本次综述的 203 条记录，其中 128 条记录用于 10 种癌症类型的定量分析：乳腺癌、结直肠癌、胃食管癌、头颈癌、肝细胞癌、肺癌、卵巢癌、胰腺癌、前列腺癌和肾癌。我们发现，在诊断患有这 10 种癌症类型的患者中，影像测量的内脏、皮下和总肥胖与总体死亡率、原发性癌症死亡或癌症进展风险增加没有显着相关性；然而，我们发现许多癌症类型具有显着或高度的异质性。例如，当与内脏肥胖相关的总死亡率的汇总 HR (95% CI) 基本为零时，异质性同样较高，如乳腺癌为 1.03 (0.55, 1.92; I2 = 58%)，结直肠癌为 0.99 (0.81, 1.21; I2 = 71%)，而当它们表现出潜在增加的风险时则为 1.77 (0.85, 1.92; I2 = 71%)。肝细胞癌为 1.60；I2 = 78%），肾癌为 1.62（0.90，2.95；I2 = 84%）。诊断时的肥胖程度（通过成像直接测量）与癌症幸存者的生存率较差无关。然而，研究中注意到了异质性和其他潜在的局限性，这表明研究设计和肥胖测量方法存在差异，使得荟萃分析的解释具有挑战性。未来标准化成像测量和数据分析的工作将加强对肥胖在癌症生存中的作用的研究。
The increasing availability of clinical imaging tests (especially CT and MRI) that directly quantify adipose tissue has led to a rapid increase in studies examining the relationship of visceral, subcutaneous, and overall adiposity to cancer survival. To summarize this emerging body of literature, we conducted a systematic review and meta-analysis of imaging-measured as well as anthropometric proxies for adipose tissue distribution and cancer survival across a wide range of cancer types. Using keywords related to adiposity, cancer and survival, we conducted a systematic search of the literature in PubMed and MEDLINE, Embase, and Web of Science Core Collection databases from database inception to June 30, 2021. We used a random-effect method to calculate pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) within each cancer type, and tested for heterogeneity using Cochran’s Q test and the I2 test. We included 203 records for this review, of which 128 records were utilized for quantitative analysis among 10 cancer types: breast, colorectal, gastroesophageal, head and neck, hepatocellular carcinoma, lung, ovarian, pancreatic, prostate, and renal cancer. We found that imaging-measured visceral, subcutaneous, and total adiposity were not significantly associated with increased risk of overall mortality, death from primary cancer, or cancer progression among patients diagnosed with these 10 cancer types; however, we found significant or high heterogeneity for many cancer types. For example, heterogeneity was similarly high when the pooled HRs (95% CI) for overall mortality associated with visceral adiposity were essentially null as in 1.03 (0.55, 1.92; I2 = 58%) for breast, 0.99 (0.81, 1.21; I2 = 71%) for colorectal, versus when they demonstrated a potential increased risk 1.77 (0.85, 1.60; I2 = 78%) for hepatocellular carcinoma and 1.62 (0.90, 2.95; I2 = 84%) for renal cancer. Greater adiposity at diagnosis (directly measured by imaging) is not associated with worse survival among cancer survivors. However, heterogeneity and other potential limitations were noted across studies, suggesting differences in study design and adiposity measurement approaches, making interpretation of meta-analyses challenging. Future work to standardize imaging measurements and data analyses will strengthen research on the role of adiposity in cancer survival.
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DOI：
10.1016/j.tipsro.2020.10.001
发表时间：
2020-12
影响因子：
--
作者：
Anjanappa M;Corden M;Green A;Roberts D;Hoskin P;McWilliam A;Choudhury A
通讯作者：
Choudhury A
影响因子：
2.5
作者：
Ballian, Nikiforos;Lubner, Meghan G.;Kennedy, Gregory D.
通讯作者：
Kennedy, Gregory D.
影响因子：
3.7
作者：
Buttigliero, Consuelo;Vana, Federica;Berruti, Alfredo
通讯作者：
Berruti, Alfredo
影响因子：
2.8
作者：
Boutin, Robert D.;Katz, Jeremy R.;Lenchik, Leon
通讯作者：
Lenchik, Leon
影响因子：
8.4
作者：
Antoun, Sami;Bayar, Amine;Loriot, Yohann
通讯作者：
Loriot, Yohann