2型糖尿病与消化系统恶性肿瘤队列研究的Meta分析

目的]探讨2型糖尿病与消化系统恶性肿瘤的关系。方法]利用Medline、Embase与Web of Science检索2012年10月之前国外公开发表的关于2型糖尿病与消化系统恶性肿瘤关系的队列研究文献。利用R软件及其Meta程序包对检索结果进行综合分析。结果]纳入分析的文献共41篇。经Meta分析后结果显示,2型糖尿病与消化系统恶性肿瘤间的相对危险度及95%可信区间为1.52（95%CI：1.40~1.66）。2型糖尿病与肝癌、食管癌、胃癌、胰腺癌、结直肠癌以及结肠癌的关联均有统计学意义,合并相对危险度分别为1.79（95%CI：1.61~1.99）,1.16（95%CI：1.07~1.27）,1.34（95%CI：1.11~1.61）,1.56（95%CI：1.49~1.64）,1.32（95%CI：1.23~1.40）和1.24（95%CI：1.15~1.33）。2型糖尿病与直肠癌合并相对危险度为1.07（95%CI：0.91~1.25）,无统计学意义。结论]2型糖尿病与消化系统恶性肿瘤密切相关,可能是肝癌、食管癌、胃癌、胰腺癌、结肠癌的危险因素之一。

A Meta-Analysis of Cohort Studies in Association with Type 2 Diabetes and Risk of Digestive System Cancer

Purpose] To investigate the relationship between type 2 diabetes and risk of digestive system cancer. Methods] The articles of association between type 2 diabetes and the risk of digestive system cancer from the cohort studies form Medline,Embase and Web of Science before October 2012 were selected. A Meta-analysis was conducted to estimate the pooled relative risks（RR） by R software and its Meta package. Results] A total of 41 articles were included in the Meta-analysis. In total,the pooled relative risk（RR） for digestive system cancer among patients with type 2 diabetes was 1.52（95%CI：1.40~1.66） compared to those non-diabetes. The results showed significantly increased risks for the common cancer sites of digestive system such as liver,esophagus,stomach,pancreas,colorectum and colon with the pooled RRs of 1.79（95%CI ：1.61~1.99）,1.16（95%CI：1.07~1.27）,1.34（95%CI：1.11~1.61）,1.56（95%CI：1.49~1.64）,1.32（95%CI：1.23~1.40） and 1.24（95%CI：1.15~1.33）,respectively. Besides,a non-significant pooled RR of1.07（95%CI：0.91~1.25） was also estimated for type 2 diabetes and the risk of rectum cancer.Conclusion] Type 2 diabetes is associated with an increased risk of digestive system cancer,and might be one of the risk factors for cancers of liver,esophagus,stomach,pancreas,and colon.