摘要
目的:系统评价牙周病与结直肠癌发病的风险关系。方法:检索万方数据、维普网、中国生物医学文献服务系统、中国知网、CENTRAL、Embase、PubMed、Web of Science数据库中有关牙周病与结直肠癌发病风险关系的队列研究,检索时间均为建库至2019年4月。由2名研究者独立按纳入排除标准筛选文献和提取数据,对纳入研究采用纽卡斯尔-渥太华量表进行质量评价,使用RevMan 5.3软件对数据进行Meta分析。结果:共纳入8项队列研究,合并样本量为346 551例,其中,牙周病组131 333例,非牙周病组215 218例。Meta分析结果表明牙周病会增加结直肠癌的发病风险[RR=1.75(1.24~2.47),P=0.001]。亚组Meta分析结果显示:1)暴露确诊方式:通过自我报告或牙科专业检查确诊为牙周病的患者结直肠癌发病风险均增加[RR=1.48(1.18~1.86),P=0.001]、[RR=1.97(1.21~3.20),P=0.006];2)随访时间:随访时间≥20年或<20年的牙周病患者结直肠癌发病风险均增加[RR=1.48(1.20~1.83),P<0.001]、[RR=2.12(1.21~3.72),P=0.009];3)研究地区:研究地点在北美洲或非北美洲地区的牙周病患者结直肠癌发病风险均增加[RR=2.00(1.13~3.54),P=0.020]、[RR=1.67(1.53~1.81),P<0.001]。结论:现有证据表明,牙周病可能会增加结直肠癌的发病风险,但上述结果尚需更多高质量研究进一步验证。
Objective: To systematically evaluate the relationship between periodontal disease and the risk of colorectal cancer. Methods: Systematic review of literature on the relationship between periodontal disease and the risk of colorectal cancer(cohort studies up to April, 2019) was conducted using 8 electronic databases: CBM, CENTRAL, CNKI, Embase, PubMed, VIP, WanFang Data and Web of Science databases. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. Newcastle-Ottawa Quality Scale(NOS) was used to evaluate the quality of included studies, and RevMan 5.3 was used to conduct meta-analysis. Results: A total of 8 cohort studies were included. The combined sample size was 346,551 cases, including 131,333 cases in the periodontal disease group and 215,218 cases in the non periodontal disease group. Meta-analysis showed that periodontal disease could increase the risk of colorectal cancer [RR=1.75(1.24~2.47),P=0.001]. Subgroup meta-analysis showed that the risk of colorectal cancer in patients with periodontal disease diagnosed by self-report or professional dental examination both increased [RR=1.48(1.18~1.86),P=0.001],[RR=1.97(1.21~3.20),P=0.006];the risk of colorectal cancer in periodontal patients with follow-up time of not less than 20 years or less than 20 years both increased [RR=1.48(1.20~1.83),P<0.001],[RR=2.12(1.21~3.72),P=0.009];the risk of colorectal cancer in periodontal patients in North America or non-North America both increased [RR=2.00(1.13~3.54),P=0.020],[RR=1.67(1.53~1.81),P<0.001]. Conclusion: Current evidence suggests that periodontal disease may increase the risk of colorectal cancer, but more high-quality studies are needed to verify the above conclusions.
作者
肖青青
夏倩
黄霞
宋小珍
黄雪花
Xiao Qingqing;Xia Qian;Huang Xia;Song Xiaozhen;Huang Xuehua(Mental Health Center,West China Hospital,Sichuan University,Chengdu 610000,Sichuan,China)
出处
《肿瘤预防与治疗》
2020年第12期954-961,共8页
Journal of Cancer Control And Treatment
关键词
牙周病
结直肠癌
队列研究
META分析
Periodontal disease
Colorectal cancer
Cohort study
Meta-analysis
