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目的基于研究证据等级较高的队列研究结果,对亚硝胺与泌尿生殖系统恶性肿瘤发生/死亡风险的关系进行系统检索和Meta分析。方法通过系统检索《中文期刊全文数据库》、《中国生物医学文献数据库》、《万方电子期刊》、Pub Med、EBSCO等文献数据库,纳入N-亚硝胺与全部恶性肿瘤、泌尿生殖系统恶性肿瘤发生/死亡风险队列研究文献,采用Rev Man 5.1软件进行Meta分析。结果本研究共检索到13篇亚硝胺与恶性肿瘤关系的队列研究文献,纳入其中含有全部恶性肿瘤和泌尿生殖系统恶性肿瘤的文献7篇进行Meta分析;亚硝胺与全种类恶性肿瘤风险存在显著性关联(RR=1.17,95%CI为1.02~1.34);与泌尿生殖系统恶性肿瘤发生风险无显著性关联(RR=0.99,95%CI为0.95~1.03),其中与卵巢癌(RR=0.87,95%CI为0.69~1.08)、乳腺癌(RR=1.03,95%CI为0.94~1.12)和前列腺癌(RR=0.97,95%CI为0.92~1.03)等生殖系统癌症无显著性关联;但是能显著增加泌尿系统膀胱癌的发生风险(RR=1.26,95%CI为1.01~1.57)。结论现有人群队列研究证据显示,亚硝胺能显著增加全部恶性肿瘤发生死亡的风险,但是与不同种类泌尿生殖系统恶性肿瘤发生风险的关系存在差异,显著增加膀胱癌风险,而与卵巢癌、乳腺癌和前列腺癌无明显关联。现有相关研究数量较少,仍需积累队列研究证据证实亚硝胺与泌尿生殖系统恶性肿瘤发生/死亡风险的关联性。
OBJECTIVE: To conduct a systematic search and meta-analysis of the relationship between nitrosamine and genitourinary malignancies in relation to the risk of death / death based on the results of a cohort of studies with high levels of evidence. Methods The literature database of Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Wanfang Electronic Journal, Pub Med and EBSCO were included in this study. All the patients were divided into N-nitrosamine group and all malignant tumor, genitourinary system malignant tumor Genesis / death risk cohort Study literature, Meta-analysis using Rev Man 5.1 software. Results A total of 13 cohort studies on the relationship between nitrosamines and malignant tumors were retrieved and included in the 7 articles containing all malignant and genitourinary malignancies for meta-analysis. The risk of nitrosamines and all kinds of malignancies (RR = 0.17, 95% CI: 1.02 ~ 1.34); there was no significant correlation with the risk of genitourinary malignancies (RR = 0.99, 95% CI 0.95 ~ 1.03) 0.87 to 95% CI 0.69 to 1.08), breast cancer (RR = 1.03, 95% CI 0.94 to 1.12), and prostate cancer (RR 0.97 95% CI 0.92 to 1.03) ; But significantly increased the risk of urinary bladder cancer (RR = 1.26, 95% CI 1.01 ~ 1.57). Conclusions The current population cohort evidences show that nitrosamines can significantly increase the risk of all malignancies to death, but with different genitourinary malignancies the risk of the existence of differences in the relationship significantly increased the risk of bladder cancer, and ovarian cancer, No significant correlation between breast and prostate cancer. There is a small number of related studies available and there is still a need to accumulate evidence from cohort studies that confirm the association between nitrosamines and the risk of genitourinary malignancies.