Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer
Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer
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DOI：
10.1016/s0016-5085(98)70422-6
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发表时间：
1998-06-01
期刊：
影响因子：
29.4
通讯作者：
Hunt, RH
中科院分区：
文献类型：
--
作者：
Huang, JQ;Sridhar, S;Hunt, RH
目的背景：关于幽门螺杆菌感染与胃癌关系的文献报道是相互矛盾的。本研究的目的是确定研究之间异质性的来源。方法：使用年龄和/或性别匹配对照的队列或病例对照研究的荟萃分析，提供通过血清学检测的幽门螺杆菌感染的原始数据。结果：完全递归文献检索确定了 19 项合格研究，涉及 2491 名患者和 3959 名对照者。同质性检验发现，早期和晚期胃癌患者（6.35 vs. 2.13；P = 0.01）、贲门型和非贲门型胃癌患者（1.23 vs. 3.08；P = 0.003）以及人群和医院对照（2.11 vs. 1.49；P < 0.001）之间的比值比存在显着差异。所有研究、队列研究和病例对照研究中，幽门螺杆菌感染患者罹患胃癌的总比值比分别为 1.92（95% 置信区间 [CI]，1.32-2.78）、2.24（95% CI，1.15-4.4）和 1.81（95% CI，1.16-2.84）。感染幽门螺杆菌的年轻患者比老年患者患胃癌的相对风险更高，比值比从小于或等于 29 岁的 9.29 降至大于或等于 70 岁的 1.05。幽门螺杆菌感染与肠癌或弥漫型胃癌同样相关。结论：幽门螺杆菌感染是胃癌的危险因素。报告结果的异质性是由对照选择、患者年龄以及胃癌部位和分期的差异引起的。
Background di Aims: Reports in the literature regarding the relationship of Helicobacter pylori infection to gastric cancer are conflicting. The aim of this study was to identify the source of heterogeneity between studies. Methods: Meta-analysis of cohort or case-control studies with age- and/or sex-matched controls, providing raw data on H. pylori infection detected by serology, was used. Results: A fully recursive literature search identified 19 qualified studies with 2491 patients and 3959 controls. Test for homogeneity found a significant difference in odds ratio between patients with early and advanced gastric cancer (6.35 vs. 2.13; P = 0.01), patients with cardiac and noncardiac gastric cancer (1.23 vs. 3.08; P = 0.003), and population and hospital-based controls (2.11 vs. 1.49; P < 0.001). The summary odds ratio for gastric cancer in H. pylori-infected patients is 1.92 (95% confidence interval [CI], 1.32-2.78), 2.24 (95% CI, 1.15-4.4), and 1.81 (95% CI, 1.16-2.84) for all studies, cohort, and case-control studies, respectively. H. pylori-infected younger patients have a higher relative risk for gastric cancer than older patients with odds ratios decreasing from 9.29 at age less than or equal to 29 years to 1.05 at age greater than or equal to 70 years. H. pylori infection is equally associated with the intestinal or diffuse type of gastric cancer. Conclusions: H. pylori infection is a risk factor for gastric cancer. The heterogeneity of reported results is caused by differences in the selection of controls, patient age, and the site and stage of gastric cancer.