论文部分内容阅读
目的为了阐明粪便中总胆汁酸和单一胆汁酸的浓度是否与大肠癌的发生有关,我们对目前所有相关文献进行了荟萃分析。方法检索以下电子数据库:Pubmed、Embase、the Cochrane Controlled Trials Register、the Science Citation Index和中文科技期刊数据库。根据纳入标准,纳入有关评价粪便胆汁酸和大肠癌/腺瘤关系的观察性试验。文献必需报道了患者和对照组的粪便中总胆汁酸、鹅脱氧胆酸、脱氧胆酸或石胆酸的浓度。我们计算加权均数差(weigh-tedmean difference,WMD)和95%可信区间(95%confidence interval,CI)。通过漏斗图肉眼观察是否存在发表偏倚,并做Begg和Egger检验进一步验证。结果我们检索到了20个病例对照研究或队列研究(共1226例)。无论是固定效应模型,还是随机效应模型,对所有研究进行汇总后均未发现粪便中总胆汁酸和大肠癌/腺瘤存在联系(WMD0.61,95%CI0·35～1·57)mg/g冻干粪)。相比对照组,大肠癌/腺瘤中鹅脱氧胆酸、脱氧胆酸和石胆酸的浓度显著增加,分别为WMD0·16、0·40、0·32,95%CI0·00～0·32,0·18～0·61,0·12～0·53mg/g冻干粪。然而初级胆汁酸和次级胆汁酸浓度却并无差异。结论粪便中总胆汁酸与大肠癌/腺瘤无关联,但鹅脱氧胆酸和石胆酸可能涉及大肠癌的发生,脱氧胆酸则可能同大肠癌和大肠腺瘤都存在联系。
Objective To elucidate whether total bile acids and single bile acids in feces are associated with the development of colorectal cancer, we conducted a meta-analysis of all current literature. Methods The following electronic databases were searched: Pubmed, Embase, the Cochrane Controlled Trials Register, the Science Citation Index and the Chinese Science and Technology Periodical Database. Based on the inclusion criteria, an observational study evaluating the relationship between fecal bile acids and colorectal cancer / adenoma was included. The literature must report the concentrations of total bile acid, chenodeoxycholic acid, deoxycholic acid or lithocholic acid in the stools of patients and controls. We calculated weigh-tedmean difference (WMD) and 95% confidence interval (CI). Visual observation through the funnel chart for publication bias and Begg and Egger test for further validation. Results We searched for 20 case-control or cohort studies (1226 in total). There was no association between total bile acid and colorectal cancer / adenoma in all stool samples, either for the fixed-effects model or for the random-effects model (WMD 0.61, 95% CI 0.35-1.57) mg / g lyophilized). Compared with the control group, the concentrations of chenodeoxycholic acid, deoxycholic acid and lithocholic acid in colorectal cancer / adenoma increased significantly, which were respectively WMD 0.16, 0.40, 0.32, 95% CI 0.00 32,0 · 18 ~ 0 · 61,0 · 12 ~ 0 · 53 · mg / g lyophilized. However, there was no difference in primary bile acid and secondary bile acid concentrations. Conclusion There is no correlation between total bile acid and colorectal cancer / adenoma in feces, but chenodeoxycholic acid and lithocholic acid may be involved in the occurrence of colorectal cancer. Deoxycholic acid may be associated with colorectal cancer and colorectal adenoma.