论文部分内容阅读
目的系统评价高密度脂蛋白(HDL-C)与肺癌的相关性。方法计算机检索Pub Med、EBSCO、ISI Web of Science、The Cochrane Library(2015年8期)、VIP和CNKI数据库,搜集高密度脂蛋白胆固醇(HDL-C)与肺癌相关性的研究,检索时间均为建库至2015年9月23日。由2位评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析。结果共纳入15个研究,包括2 015例患者和15 505例对照。Meta分析结果显示,HDL-C水平与肺癌发病相关[SMD=–0.68,95%CI(–0.97,–0.40),P=0.000]。亚组分析结果显示,不同临床分级[SMD_(~Ⅱ)=–0.65,95%CI(–1.07,–0.23),P=0.002;SMD_(Ⅲ~Ⅳ)=–0.61、95%CI(–0.73,–0.50),P=0.000]、不同病理类型(除非小细胞肺癌)[SMD_(腺癌)=–0.76、95%CI(–1.13,–0.38),P=0.000;SMD_(鳞癌)=–1.51、95%CI(–2.47,–0.56),P=0.010;SMD_(小细胞肺癌)=–1.19、95%CI(–1.42,–0.95),P=0.000]、不同研究质量评分[SMD_(≥6分)=–0.60、95%CI(–0.89,–0.29),P=0.000;SMD_(<6分)=–0.77、95%CI(–1.48,–0.06),P=0.015]、不同研究例数[SMD_(≥100例)=–0.48、95%CI(–0.80,–0.15),P=0.004;SMD_(<100例)=–0.80、95%CI(–1.33,–0.27),P=0.003]、吸烟[SMD=–1.47、95%CI(–2.51,–0.43),P=0.006]以及亚洲地区[SMD=–0.92、95%CI(–1.21,–0.63),P=0.000]肺癌的发病均与HDL-C水平相关。结论 HDL水平与肺癌发病相关,低水平HDL-C会增大肺癌的发生风险。鉴于纳入研究的局限性,上述结论尚需进一步开展更多大样本,且调整了吸烟状态的前瞻性队列研究加以验证。
Objective To evaluate the relationship between high density lipoprotein (HDL-C) and lung cancer. Methods The databases of Pub Med, EBSCO, ISI Web of Science, The Cochrane Library (2015), VIP and CNKI were searched by computer. The correlation between high density lipoprotein cholesterol (HDL-C) Building the library until September 23, 2015. After two independent reviewers screened the literature, extracted data and assessed the risk of being included in the study, the Stata 12.0 software was used for meta-analysis. Results A total of 15 studies were included, including 2,015 patients and 15,505 controls. Meta-analysis showed that the level of HDL-C correlated with the incidence of lung cancer [SMD = -0.68, 95% CI (-0.97, -0.40), P = 0.000]. The results of subgroup analysis showed that there was no significant difference between the two groups (SMD_ (~ Ⅱ) = - 0.65,95% CI (-1.07, -0.23), P = 0.002; SMD_ (Ⅲ ~ Ⅳ) = -0.61, 95% CI , -0.50), P = 0.000], with different pathological types (except for small cell lung cancer) [SMD_ (adenocarcinoma) = - 0.76, 95% CI (-1.13, -0.38), P = -1.51, 95% CI (-2.47, -0.56), P = 0.010; SMD_ (small cell lung cancer) = -1.19,95% CI -1.42, -0.95, P = 0.000] (≥6 points) = -0.60, 95% CI (-0.89, -0.29), P = 0.000; SMD_ (6 points) = -0.77, 95% CI -1.48, -0.06) The number of different studies [SMD_ (≥100) = - 0.48,95% CI (-0.80, -0.15), P = 0.004; SMD_ (<100) = -0.80,95% CI (-1.33, -0.27) , P = 0.003], smoking [SMD = -1.47,95% CI (-2.51, -0.43), P = 0.006] and the Asian region [SMD = -0.92,95% CI (-1.21, -0.63) 0.000] The incidence of lung cancer are associated with HDL-C levels. Conclusions HDL levels are associated with the development of lung cancer. Low-level HDL-C may increase the risk of lung cancer. In view of the limitations of the included studies, the above conclusion still needs to be followed by more large samples, and the prospective cohort study with adjusted smoking status needs to be verified.