非甾体抗炎药降低胃癌患病风险的系统评价

目的系统评价非甾体抗炎药降低胃癌患病风险的有效性。方法检索Cochranelibrary、MEDLINE、EMBASE、CBM、CNKI和VIP等数据库（截至2008年8月），全面搜集有关非甾体抗炎药（NSAIDs）降低胃癌患病风险的研究，文献质量评价参照Cochrane系统评价员手册。纳入非甾体类抗炎药降低胃癌患病风险的研究，采用CochraneHandbook4．2．5的方法进行评价，同质的研究用RevMan4．2．7软件合并效应量，进行Meta分析。结果共检索到19篇相关文献，评价后纳入9篇文献（9个研究28721名受试者）。纳入研究均为非甾体抗炎药与胃癌患病风险的研究，其中4个研究为单用阿司匹林与胃癌的患病研究，另外5个研究为阿司匹林和非阿司匹林非甾体抗炎药与胃癌的患病研究的对比研究。9个研究均为病例对照研究。按照不同的统计学分组，经异质性检验，无统计学异质性，合并统计量进行分析：结果显示，阿司匹林等非甾体抗炎药为胃癌的保护因素[OR0．73，95％CI（0．68，0．79）].结论长期、规律地使用阿司匹林等非甾体抗炎药有助于降低胃癌的患病风险；目前尚无足够的证据显示短期使用非甾体抗炎药有助于降低胃癌的患病风险。

Systematic review of non-steroidal anti-inflammatory drugs reduce the risk of gastric cancer

Objective To assess the efficiency in use of non-steroidal anti-inflammatory drugs to reduce the risk of gastric cancer. Methods A fully recursive literature search was conducted in Cochrane library,MED- LINE,EMBASE,CBM,CNKI,VIP （before August 2008 ） to identify all potentially relevant studies including randomized controlled trails,case-control or cohort studies. Summary odds ratios （ORs） and 95% confidence intervals （CIs） were calculated under a random-effects model. Meta-analyses were performed using The Cochrane Collaboration＇s RevMan4. 2. 7. Results We identified 19 relevont studies in total with the computerized search. No randomized controlled clinical study was searched. However, after screening of the titles and abstracts of all these citations, 10 were excluded. We identified 9 case-control studies including 28721 subjects. All included studies were about the study of NSAIDs and gastric cancer. Among them, 4 studies were about Aspirin and gastric cancer. Another 5 studies were about Aspirin and/or NSAIDs and gastric cancer. All of 9 studies were case-control studies. In accordance with the different statistical division,we divided them into 7 groups. After heterogeneity test, we merged and analyzed the statistics. The results showed that Aspirin and NSAIDs were protective factors to gastric cancer. Conclusions Aspirin and NSAIDs were associated with a reduced risk of gastric cancer in a long-term and regular use. There was no reduction in risk of gastric cancer associated with short-term Aspirin and/or NSAIDs use.