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目的探讨叶酸摄入与胰腺癌发生风险的关系。方法计算机检索Cochrane图书馆、Pubmed、Embase、CBM-disc、CNKI数据库,手工检索相关文献,纳入关于叶酸与胰腺癌发生关系的前瞻性及病例-对照研究。评价质量及提取资料后,采用Stata version 11.0软件对胰腺癌发生风险进行合并。结果共纳入6项队列研究及3项病例-对照研究,2 209例患者。分析提示:从食物中获取叶酸的最高摄入量人群与最低者相比,前组胰腺癌罹患风险统计学上明显降低28%,在以相对危险度(RR)为效应值的队列研究中这种降低趋势更明显[合并RR=0.51,95%CI(0.29,0.89),P=0.017],在病例-对照研究中,合并优势比(OR)=0.79[95%CI(0.66,0.94),P=0.008];总叶酸摄入量(来源于食物及补充的叶酸)最高组人群与最低者相比,胰腺癌罹患风险统计学上明显降低33%,在病例-对照研究中,合并OR=0.53[95%CI(0.30,0.96),P=0.036]。结论本研究结果表明增加总叶酸摄入量(来源于食物及补充的叶酸)及食物来源叶酸摄入量是胰腺的保护因素。
Objective To investigate the relationship between the intake of folic acid and the risk of pancreatic cancer. Methods The Cochrane Library, Pubmed, Embase, CBM-disc and CNKI databases were searched by computer and related literature was searched by hand. Prospective and case-control studies on the relationship between folic acid and pancreatic cancer were included. After evaluating the quality and extracting data, the risk of pancreatic cancer was merged using Stata version 11.0 software. Results A total of 6 cohort studies and 3 case-control studies were included, with 2,209 patients. Analysis suggests that the highest intake of folic acid from food was found in patients with a statistically significant 28% reduction in the risk of pancreatic cancer in the population compared with the lowest, and in a cohort study of relative risk (RR) (RR = 0.51, 95% CI 0.29, 0.89, P = 0.017). In the case-control study, the odds ratio was 0.79 (95% CI 0.66, 0.94) P = 0.008]. The highest risk of pancreatic cancer was significantly lower by 33% in the highest total folic acid intake group (foods and supplemented folic acid) compared with the lowest, and in the case-control study, OR = 0.53 [95% CI (0.30, 0.96), P = 0.036]. Conclusion The results of this study indicate that increasing total folic acid intake (derived from food and supplemented folic acid) and food intake of folic acid are protective factors of the pancreas.