{"title":"Is <i>Helicobacter pylori</i> infection associated with pancreatic cancer? A systematic review and meta-analysis of observational studies.","authors":"Ben-Gang Zhou, Yu-Zhou Mei, Jing-Shu Wang, Jian-Lei Xia, Xin Jiang, Sheng-Yong Ju, Yan-Bing Ding","doi":"10.1177/20406223231155119","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Recent observational studies have investigated the association between <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and pancreatic cancer with conflicting data. Therefore, we conducted a systematic review and meta-analysis to assess the potential association.</p><p><strong>Design: </strong>This is a systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched three databases (PubMed, Embase, and Web of Science) from inception to 30 August 2022. The summary results as odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were pooled by generic inverse variance method based on random-effects model.</p><p><strong>Results: </strong>A total of 20 observational studies involving 67,718 participants were included in the meta-analysis. Meta-analysis of data from 12 case-control studies and 5 nested case-control studies showed that there was no significant association between <i>H. pylori</i> infection and the risk of pancreatic cancer (OR = 1.20, 95% CI = 0.95-1.51, <i>p</i> = 0.13). Similarly, we also did not find significant association between cytotoxin-associated gene A (CagA) positive strains, CagA negative strains, vacuolating cytotoxin gene A (VacA) positive strains <i>H. pylori</i> infection, and the risk of pancreatic cancer. Meta-analysis of data from three cohort studies showed that <i>H. pylori</i> infection was not significantly associated with an increased risk of incident pancreatic cancer (HR = 1.26, 95% CI = 0.65-2.42, <i>p</i> = 0.50).</p><p><strong>Conclusion: </strong>We found insufficient evidence to support the proposed association between <i>H. pylori</i> infection and increased risk of pancreatic cancer. To better understand any association, future evidence from large, well-designed, high-quality prospective cohort studies that accounts for diverse ethnic populations, certain <i>H. pylori</i> strains, and confounding factors would be useful to settle this controversy.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231155119"},"PeriodicalIF":3.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/a4/10.1177_20406223231155119.PMC9986679.pdf","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Chronic Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20406223231155119","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 2
Abstract
Background and objectives: Recent observational studies have investigated the association between Helicobacter pylori (H. pylori) infection and pancreatic cancer with conflicting data. Therefore, we conducted a systematic review and meta-analysis to assess the potential association.
Design: This is a systematic review and meta-analysis.
Methods: We searched three databases (PubMed, Embase, and Web of Science) from inception to 30 August 2022. The summary results as odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were pooled by generic inverse variance method based on random-effects model.
Results: A total of 20 observational studies involving 67,718 participants were included in the meta-analysis. Meta-analysis of data from 12 case-control studies and 5 nested case-control studies showed that there was no significant association between H. pylori infection and the risk of pancreatic cancer (OR = 1.20, 95% CI = 0.95-1.51, p = 0.13). Similarly, we also did not find significant association between cytotoxin-associated gene A (CagA) positive strains, CagA negative strains, vacuolating cytotoxin gene A (VacA) positive strains H. pylori infection, and the risk of pancreatic cancer. Meta-analysis of data from three cohort studies showed that H. pylori infection was not significantly associated with an increased risk of incident pancreatic cancer (HR = 1.26, 95% CI = 0.65-2.42, p = 0.50).
Conclusion: We found insufficient evidence to support the proposed association between H. pylori infection and increased risk of pancreatic cancer. To better understand any association, future evidence from large, well-designed, high-quality prospective cohort studies that accounts for diverse ethnic populations, certain H. pylori strains, and confounding factors would be useful to settle this controversy.
背景和目的:最近的观察性研究调查了幽门螺杆菌感染与胰腺癌之间的关系，但数据相互矛盾。因此，我们进行了系统回顾和荟萃分析，以评估潜在的关联。设计:这是一项系统回顾和荟萃分析。方法:我们检索了三个数据库(PubMed、Embase和Web of Science)，检索时间从成立到2022年8月30日。采用基于随机效应模型的通用反方差法，将汇总结果以95%置信区间(CI)的优势比(OR)或风险比(HR)进行汇总。结果:meta分析共纳入20项观察性研究，涉及67,718名参与者。对12项病例对照研究和5项嵌套病例对照研究的meta分析显示，幽门螺杆菌感染与胰腺癌风险无显著相关性(OR = 1.20, 95% CI = 0.95-1.51, p = 0.13)。同样，我们也没有发现细胞毒素相关基因A (CagA)阳性菌株、CagA阴性菌株、空泡细胞毒素基因A (VacA)阳性菌株幽门螺杆菌感染与胰腺癌风险之间存在显著相关性。三项队列研究数据的荟萃分析显示，幽门螺杆菌感染与胰腺癌发病风险增加无显著相关(HR = 1.26, 95% CI = 0.65-2.42, p = 0.50)。结论:我们发现没有足够的证据支持幽门螺杆菌感染与胰腺癌风险增加之间的关联。为了更好地理解任何关联，未来来自大型、设计良好、高质量的前瞻性队列研究的证据将有助于解决这一争议，这些研究将考虑到不同种族人群、某些幽门螺杆菌菌株和混杂因素。
期刊介绍：
Therapeutic Advances in Chronic Disease publishes the highest quality peer-reviewed research, reviews and scholarly comment in the drug treatment of all chronic diseases. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers involved in the medical treatment of chronic disease, providing a forum in print and online for publishing the highest quality articles in this area.
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