中国人群结直肠癌危险因素的 Meta 分析

目的综合评价中国人群结直肠癌的危险因素,为结直肠癌的预防控制决策提供参考依据。方法计算机检索中国生物医学文献数据库、中国期刊全文数据库、维普数据库、万方数据库和PubMed,并辅以文献追溯方法,收集国内1985年1月至2012年11月公开发表的关于中国人群结直肠癌危险因素的研究文献,经Newcastle—Ottawa Seale（NOS）标准质量评价后采用RevMan5．1分析软件对入选的文献进行异质性检验,经Meta分析计算合并OR值及其95％CI。结果纳人合格研究文献25篇,累计病例6646例,对照9957例。Meta分析显示有统计学意义的结果：轻体力活动、饮茶、奶及其制品、葱蒜类食物、粗粮、蔬菜、水果等因素的合并OR值在0～1之间;吸烟、被动吸烟、情绪自我调节能力差、油炸或烟熏以及腌制食品、红肉、动物油、肥肉、饮食偏咸、痔疮史、胆囊疾病史、肿瘤家族史等因素的合并OR值在1-2之间;精神创伤史、烧烤食品、饮食油腻、阑尾炎史、胃及十二指肠溃疡、慢性结直肠炎、直系亲属肿瘤史、旁系亲属肿瘤史等因素的合并OR值在2-5之间;肠息肉、黏液血便、慢性便秘或腹泻等因素的合并OR值大于5。结论生活方式、精神刺激、烹调方式不当、饮食油腻等、肠道相关症状或疾病、家族肿瘤史与结直肠癌的发生有关;而轻体力活动、饮茶、奶制品、膳食纤维为保护性因素,为结直肠癌的早期预防提供了科学依据。

Meta-analysis of the risk factor of colorectai cancer in China

Objective To comprehensively evaluate the risk factors of colorectal cancer in China and to provide the basis for prevention and control of eolorectal cancer. Methods The published studies were searched in the CBM, CNKI, VIP, WanFang databases and PubMed, and other relevant journals were also hand-searched to identify all the relevant case-control studies conducted from Jane of 1985 to Nov. of 2012. After the data-quality of collected studies was assessed using Newcastle-Ottawa Scale （NOS） criteria, the homogeneity of the data was tested by RevMan5.1 software. Meta-analysis was applied to calculate the pooled odds ratio and 95% confidence intervals. Results Total 25 original articles were recruited into recta-analysis according to the selection criteria. The cumulative cases and controls were 6 646 and 9 957, respectively. The meta-analysis showed that the pooled odds ratio values of mild physical activity, drinking tea, milk and its products, onion and garlic foods, whole grains, vegetables and fruits were between 0 and 1; the pooled odds ratio values of smoking, passive smoking, poor emotional self-regulation capacity, fried or smoked and preserved foods, red meat, animal oil, fat, sahy diet, medical history of hemorrhoids, or gallbladder disease, and family history of cancer were between 1 and 2; the pooled odds ratio values of trauma history, barbecue food, eating greasy, appendicitis history, gastrointestinal ulcer, chronic colitis, family history of cancer were between 2 and 5; the pooled odds ratio values of intestinal polyps, mucus bloody stools, chronic constipation and diarrhea were greater than 5. Conclusion The lifestyles, mental trauma, the cooking way, fatty food, medical history of intestinal conditions, and family history of cancers are positively correlated to the coloreetal cancer; the mild physical activity, drinking tea, milk and its products, dietary fibers are protective factors.