背景:以前的文献探讨了慢性萎缩性胃炎(CAG)与上消化道癌中孤立性癌症之间的关系;然而,明显缺乏整个上消化道癌症的综合合成。研究目的是评估CAG与上消化道癌发病风险之间的关系。特别包括胃癌,食道癌,和食管胃结合部癌。
方法:在三个主要数据库中进行了严格的系统搜索,即PubMed,Embase和WebofScience,涵盖从数据库开始到2023年8月10日的时间表。我们提取了必要的比值比(OR)及其相应的95%置信区间(CI),用于后续的荟萃分析。采用Stata17.0软件进行统计分析。
结果:本荟萃分析共纳入23篇文章,包括5858例上消化道癌症患者。CAG导致发生胃癌的风险增加4.12倍(OR=4.12,95%CI3.20-5.30)。同样,CAG与发生食管癌的风险增加2.08倍相关(OR=2.08,95CI1.60-2.72)。有趣的是,发现CAG与食管鳞状细胞癌的发生风险之间存在特定的相关性(OR=2.29,95CI1.77-2.95),而未检测到食管腺癌的显著相关性(OR=0.62,95CI0.17-2.26)。此外,CAG与食管胃结合部癌的风险增加2.77倍相关(OR=2.77,95CI2.21-3.46)。值得注意的是,对于相同类型的上消化道癌症,观察到,与通过血清学方法诊断CAG相比,通过组织学方法诊断CAG与发生癌症的风险高33-77%相关.
结论:这项荟萃分析表明,胃癌的风险增加了两到四倍,食道癌,和食管胃结合部癌患者的CAG。重要的是,同样的上消化道癌症,与血清学诊断相比,组织学诊断为CAG时发生癌症的风险更高.需要进一步严格的研究设计来探索通过两种诊断方法诊断的CAG对上消化道癌症风险的影响。
BACKGROUND: Previous literature has explored the relationship between chronic atrophic gastritis (CAG) and isolated cancers within the upper gastrointestinal cancers; However, an integrative synthesis across the totality of upper gastrointestinal cancers was conspicuously absent. The research objective was to assess the relationship between CAG and the risk of incident upper gastrointestinal cancers, specifically including gastric cancer, oesophageal cancer, and oesophagogastric junction cancer.
METHODS: Rigorous systematic searches were conducted across three major databases, namely PubMed, Embase and Web of Science, encompassing the timeline from database inception until August 10, 2023. We extracted the necessary odds ratio (OR) and their corresponding 95% confidence interval (CI) for subsequent meta-analysis. Statistical analyses were conducted using Stata 17.0 software.
RESULTS: This meta-analysis included a total of 23 articles encompassing 5858 patients diagnosed with upper gastrointestinal cancers. CAG resulted in a statistically significant 4.12-fold elevated risk of incident gastric cancer (OR = 4.12, 95% CI 3.20-5.30). Likewise, CAG was linked to a 2.08-fold increased risk of incident oesophageal cancer (OR = 2.08, 95%CI 1.60-2.72). Intriguingly, a specific correlation was found between CAG and the risk of incident oesophageal squamous cell carcinoma (OR = 2.29, 95%CI 1.77-2.95), while no significant association was detected for oesophageal adenocarcinoma (OR = 0.62, 95%CI 0.17-2.26). Moreover, CAG was correlated with a 2.77-fold heightened risk of oesophagogastric junction cancer (OR = 2.77, 95%CI 2.21-3.46). Notably, for the same type of upper gastrointestinal cancer, it was observed that diagnosing CAG through histological methods was linked to a 33-77% higher risk of developing cancer compared to diagnosing CAG through serological methods.
CONCLUSIONS: This meta-analysis indicated a two- to fourfold increased risk of gastric cancer, oesophageal cancer, and oesophagogastric junction cancer in patients with CAG. Importantly, for the same upper gastrointestinal cancer, the risk of incident cancer was higher when CAG was diagnosed histologically compared to serological diagnosis. Further rigorous study designs are required to explore the impact of CAG diagnosed through both diagnostic methods on the risk of upper gastrointestinal cancers.