S1427 Is Acid Suppression Therapy Associated With Increased Risk of Cardia Gastric Cancer? A Meta-Analysis
Notice bibliographique
Résumé
Introduction: Gastric cancer (GC) ranks as the 3rd most common cause of cancer-related deaths and is the 5th most common cause of cancer overall. Among GC, anatomic cardia gastric cancer (CGC) is less common and generally follows the same demographic and risk factor profile as esophageal adenocarcinoma or adenocarcinoma at the gastroesophageal junction. Acid-suppression therapy, including proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) have been reported to be associated with an increased risk of gastrointestinal tract cancers, but conclusions of previous studies were inconsistent. Thus, this meta-analysis was conducted. Methods: A comprehensive literature search on PubMed, Web of Science, and CNKI were conducted to identify all relevant studies published prior to May 2021 according to the established inclusion criteria. The quality assessment was performed by the Newcastle-Ottawa Scale (NOS). The pooled odds risk (OR) and 95% confidence intervals (CI) were calculated to estimate the association between the acid-suppression therapy and CGC risk. A random-effect or fixed-effect model was used to calculate the pooled OR, based on heterogeneity significance. Subgroup analyses were conducted by acid suppressant type, study location, and sample size. Sensitivity analysis and publication bias detection were also performed. All statistical analyses were performed using RevMan software (version 5.4.1; Cochrane library) and STATA 15.1 statistical software (Stata Corp., College Station, TX), and all P values were two-tailed, the test level was 0.05. Results: Three hundred and twenty-six articles were obtained, and 5 moderate to high-quality articles with 86,845 participants were included. No statistically significant association between acid-suppression therapy and CGC risk was found (OR 1.23, 95% CI: 0.83, 1.82, P = 0.29, I2 = 54%). In subgroup analyses based on acid suppressant type, study location, and sample size, similar conclusions were also found as shown in the table. Sensitivity analysis by changing effect models confirmed the relative stability of the result. Funnel plot, Egger's test, and Begg's test found no publication bias of analysis. Conclusion: The current meta-analysis demonstrates no association between acid-suppression therapy and increased CGC risk. However, more original studies are still needed to further clarify this conclusion.Table 1.: Results of quality assessment and Results of subgroups analyses. PPIs: Proton pump inhibitors; H2RA: H2 receptor antagonists, N/A: Not applicable.Figure 1.: Forest plot showing the occurrence of gastric cancer in a) patients with Juvenile Polyposis Syndrome. b) patients with SMAD4 PV related Juvenile Polyposis syndrome.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».