摘要
目的:对5-氨基水杨酸(5-ASA)干预炎症性肠病(IBD)相关性结肠癌(CRC)或上皮内瘤变(Dys)(IBD-CRC/Dys)的作用进行临床资料的评价和meta分析。方法:检索PubMed、Web of Science、the Cochrane Library等主要数据库,将符合标准的资料纳入研究,统计优势比(OR)及其95%置信区间(CI),并根据IBD类型和疗程进行亚组分析。结果:共纳入15篇文献中的5038名IBD患者。使用5-ASA的IBD患者发生CRC/Dys的OR=0.53(95%CI:0.37~0.76)。根据疾病类型分层分析显示,使用5-ASA的溃疡性结肠炎患者发生CRC/Dys的OR=0.45(95%CI:0.27~0.77),克罗恩病患者发生CRC/Dys的OR=0.39(95%CI:0.16~0.97);此外,疗程小于1年的患者发生CRC/Dys的OR=0.59(95%CI:0.26~1.34),而疗程在1年以上(最长者达20年)发生CRC/Dys的OR=0.43(95%CI:0.25~0.74)。结论:5-ASA对IBD-CRC/Dys有预防作用,且该作用呈疗程依赖性,疗程长者效果明显,尚不能证明2~6个月的使用疗程有预防作用。
AIM:We conducted an evaluation of clinical data with meta analysis to investigate the preventive effect of 5-aminosalicylic acid(5-ASA)on inflammatory bowel disease(IBD)-associated colorectal cancer(CRC)or dysplasia(Dys)(IBD-CRC/Dys).METHODS:The information was retrieved from the main databases such as PubMed,Web of Science,the Cochrane Library,etc.All full-text articles about the prevention of IBD-CRC/Dys by 5-ASA were included if they conformed to the standards.The odds ratio(OR)and its 95%confidence interval(CI)were calculated.According to the types of IBD and the treatment course,the subgroup analysis was conducted,respectively.RESULTS:Fifteen articles were selected,including 5038 IBD patients.Pooled analysis showed a protective association between 5-ASA and IBD-CRC/Dys(OR=0.53,95%CI:0.37~0.76).Among them,both ulcerative colitis patients(OR=0.45,95%CI:0.27~0.77)and Crohn disease patients(OR=0.39,95%CI:0.16~0.97)with 5-ASA therapy were less likely to develop CRC/Dys compared with those without 5-ASA treatment.5-ASA treatment for 1~20 years shows a preventive benefit(OR=0.43,95%CI:0.25~0.74).However,a minimum 5-ASA exposure of 2~6 months did not show a preventive benefit(OR=0.59,95%CI:0.26~1.34).CONCLUSION:5-ASA protects against CRC/Dys in IBD patients.Additionally,the protective effect is treatment time dependent.Treatment course for 1~20 years shows an evident preventive benefit.
作者
杨莉芝
林思思
李永渝
YANG Li-zhi;LIN Si-si;LI Yong-yu(Department of Pathophysiology,Institute of Digestive Diseases,Tongji University School of Medicine,Shanghai 200092,China.)
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2014年第10期1813-1819,共7页
Chinese Journal of Pathophysiology
基金
国家自然科学基金资助项目(No.81270477)
关键词
氨基水杨酸
炎症性肠疾病
结直肠肿瘤
Meta分析
Aminosalicylic acid
Inflammatory bowel disease
Colorectal neoplasms
Meta-analysis
