Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis

IF 1.6 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Current Therapeutic Research-clinical and Experimental Pub Date : 2023-01-01 DOI:10.1016/j.curtheres.2023.100692

Karamali Kasiri Associate , Catherine M.T. Sherwin Professor , Sahar Rostamian MD , Saeid Heidari-Soureshjani MSc

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引用次数: 4

Abstract

Background

Esophageal cancer is a cancerous tumor that develops in the esophagus. It is the 10th most common cancer and has a low survival rate. Esophageal adenocarcinoma (EAC) is increasing in incidence globally. Those with EAC are affected by Barrett's esophagus metaplasia, which is attributed to genetic predisposition and is more common in men. Studies suggest that gastric acid suppressants, like proton pump inhibitors and histamine-2 receptor antagonists, have anticancer properties and reduce EAC. However, other research has suggested that they are not cancer-protective, and the use of antisecretory drugs is a risk factor for developing EAC.

Objective

This systematic review and meta-analysis investigated the properties and risk factors associated with using gastric acid suppressants in patients with EAC.

Methods

This meta-analysis used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Information from selected articles, including the lead author's name, year of publication, study setting, sample size, and gender, was extracted and recorded into an Excel (Microsoft, Redmond, Washington) form. Statistical data included odds ratio, hazard ratio, and/or risk ratio, with a 95% CI associated with patients with EAC and receiving gastric acid suppressants. Data were compared with individuals not receiving treatment. Publication bias was assessed using Begg's and Egger's tests. Statistical analyzes used Stata 14.0 (Stata LLC, College Station, Texas).

Results

The initial electronic literature search retrieved 3761 titles/abstracts. Extensive screening selected 20 articles for analysis. Odds ratios associated with EAC in the individuals using gastric acid suppressants were 0.77 (95% CI, 0.49–1.22; P = 0.274) and 0.67 (95% CI, 0.39–1.29; P = 0.240) for proton pump inhibitors and 1.02 (95% CI, 0.44-2.36; P = 0.967) for histamine-2 receptor antagonists.

Conclusions

The results found that gastric acid suppressants do not have a protective role in EAC and are not risk factors. Future studies of confounding variables and risk factors are needed to understand what affects EAC development.

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胃酸抑制剂与食管腺癌风险关系的评估:系统回顾和荟萃分析

背景食管癌症是一种发生于食管的恶性肿瘤。它是第十大最常见的癌症，存活率很低。食管腺癌（EAC）的发病率在全球范围内呈上升趋势。EAC患者受到Barrett食管化生的影响，这归因于遗传易感性，在男性中更常见。研究表明，胃酸抑制剂，如质子泵抑制剂和组胺-2受体拮抗剂，具有抗癌特性，可降低EAC。然而，其他研究表明，它们不是癌症保护性的，抗分泌药物的使用是患EAC的一个风险因素。目的本系统综述和荟萃分析调查了EAC患者使用胃酸抑制剂的相关特性和风险因素。方法本荟萃分析使用了系统综述和元分析的首选报告项目检查表。从所选文章中提取信息，包括主要作者的姓名、发表年份、研究环境、样本量和性别，并记录在Excel（Microsoft，Redmond，Washington）表格中。统计数据包括优势比、危险比和/或风险比，95%的CI与EAC患者和接受抑酸药的患者有关。将数据与未接受治疗的个体进行比较。发表偏倚采用Begg和Egger检验进行评估。统计分析使用Stata 14.0（Stata LLC，College Station，Texas）。结果最初的电子文献搜索检索到3761篇标题/摘要。广泛筛选出20篇文章进行分析。在使用胃酸抑制剂的个体中，与EAC相关的比值比为0.77（95%CI，0.49-1.22；P = 0.274）和0.67（95%CI，0.39–1.29；P = 0.240）和1.02（95%CI，0.44-2.36；P = 0.967）用于组胺-2受体拮抗剂。结论胃酸抑制剂对EAC无保护作用，也不是EAC的危险因素。未来需要对混杂变量和风险因素进行研究，以了解影响EAC发展的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Therapeutic Research-clinical and Experimental 医学-药学

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

3 months

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