{"title":"食管裂孔疝与巴雷特食管之间的关系：最新荟萃分析与试验序列分析。","authors":"Shaoze Ma, Zhenhua Tong, Yong He, Yiyan Zhang, Xiaozhong Guo, Xingshun Qi","doi":"10.1177/17562848231219234","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Barrett's esophagus (BE) is a precursor of esophageal adenocarcinoma. It is critical to recognize the risk factors associated with BE.</p><p><strong>Objectives: </strong>The present meta-analysis aims to systematically estimate the association of hiatal hernia with the risk of BE.</p><p><strong>Design: </strong>A meta-analysis with trial sequential analysis.</p><p><strong>Data sources and methods: </strong>The PubMed, EMBASE, and Cochrane Library databases were searched. The pooled odds ratios (ORs) and adjusted ORs (aORs) with their 95% confidence intervals (CIs) were calculated for the combined estimation of unadjusted data and data adjusted for confounders, respectively. Heterogeneity was quantified using the Cochrane <i>Q</i> test and <i>I</i>² statistics. Subgroup, meta-regression, and leave-one-out sensitivity analyses were employed to explore the sources of heterogeneity.</p><p><strong>Results: </strong>Forty-seven studies with 131,517 participants were included. Based on the unadjusted data from 47 studies, hiatal hernia was significantly associated with an increased risk of any length BE (OR = 3.91, 95% CI = 3.31-4.62, <i>p</i> < 0.001). The heterogeneity was significant (<i>I</i>² = 77%; <i>p</i> < 0.001) and the definition of controls (<i>p</i> = 0.014) might be a potential contributor to heterogeneity. Based on the adjusted data from 14 studies, this positive association remained (aOR = 3.26, 95% CI = 2.44-4.35, <i>p</i> < 0.001). The heterogeneity was also significant (<i>I</i>² = 65%; <i>p</i> < 0.001). Meta-analysis of seven studies demonstrated that hiatal hernia was significantly associated with an increased risk of long-segment BE (LSBE) (OR = 10.01, 95% CI = 4.16-24.06, <i>p</i> < 0.001). The heterogeneity was significant (<i>I</i>² = 78%; <i>p</i> < 0.001). Meta-analysis of seven studies also demonstrated that hiatal hernia was significantly associated with an increased risk of short-segment BE (OR = 2.76, 95% CI = 2.05-3.71, <i>p</i> < 0.001). The heterogeneity was not significant (<i>I</i>² = 30%; <i>p</i> = 0.201).</p><p><strong>Conclusion: </strong>Hiatal hernia should be a significant risk factor for BE, especially LSBE.</p><p><strong>Registration: </strong>PROSPERO registration number CRD42022367376.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771746/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between hiatal hernia and Barrett's esophagus: an updated meta-analysis with trial sequential analysis.\",\"authors\":\"Shaoze Ma, Zhenhua Tong, Yong He, Yiyan Zhang, Xiaozhong Guo, Xingshun Qi\",\"doi\":\"10.1177/17562848231219234\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Barrett's esophagus (BE) is a precursor of esophageal adenocarcinoma. It is critical to recognize the risk factors associated with BE.</p><p><strong>Objectives: </strong>The present meta-analysis aims to systematically estimate the association of hiatal hernia with the risk of BE.</p><p><strong>Design: </strong>A meta-analysis with trial sequential analysis.</p><p><strong>Data sources and methods: </strong>The PubMed, EMBASE, and Cochrane Library databases were searched. The pooled odds ratios (ORs) and adjusted ORs (aORs) with their 95% confidence intervals (CIs) were calculated for the combined estimation of unadjusted data and data adjusted for confounders, respectively. Heterogeneity was quantified using the Cochrane <i>Q</i> test and <i>I</i>² statistics. Subgroup, meta-regression, and leave-one-out sensitivity analyses were employed to explore the sources of heterogeneity.</p><p><strong>Results: </strong>Forty-seven studies with 131,517 participants were included. Based on the unadjusted data from 47 studies, hiatal hernia was significantly associated with an increased risk of any length BE (OR = 3.91, 95% CI = 3.31-4.62, <i>p</i> < 0.001). The heterogeneity was significant (<i>I</i>² = 77%; <i>p</i> < 0.001) and the definition of controls (<i>p</i> = 0.014) might be a potential contributor to heterogeneity. Based on the adjusted data from 14 studies, this positive association remained (aOR = 3.26, 95% CI = 2.44-4.35, <i>p</i> < 0.001). The heterogeneity was also significant (<i>I</i>² = 65%; <i>p</i> < 0.001). Meta-analysis of seven studies demonstrated that hiatal hernia was significantly associated with an increased risk of long-segment BE (LSBE) (OR = 10.01, 95% CI = 4.16-24.06, <i>p</i> < 0.001). The heterogeneity was significant (<i>I</i>² = 78%; <i>p</i> < 0.001). Meta-analysis of seven studies also demonstrated that hiatal hernia was significantly associated with an increased risk of short-segment BE (OR = 2.76, 95% CI = 2.05-3.71, <i>p</i> < 0.001). The heterogeneity was not significant (<i>I</i>² = 30%; <i>p</i> = 0.201).</p><p><strong>Conclusion: </strong>Hiatal hernia should be a significant risk factor for BE, especially LSBE.</p><p><strong>Registration: </strong>PROSPERO registration number CRD42022367376.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-01-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771746/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848231219234\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848231219234","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
背景：巴雷特食管（BE）是食管腺癌的前兆。认识与巴雷特食管相关的风险因素至关重要：本荟萃分析旨在系统评估食管裂孔疝与食管癌风险的相关性：数据来源和方法：检索了PubMed、EMBASE和Cochrane图书馆数据库。在对未调整数据和混杂因素调整数据进行综合估算后，分别计算了汇总的几率比（ORs）和调整后的几率比（aORs）及其95%置信区间（CIs）。异质性采用 Cochrane Q 检验和 I² 统计量进行量化。为了探究异质性的来源，还采用了分组分析、元回归分析和排除敏感性分析：共纳入 47 项研究，131,517 名参与者。根据 47 项研究的未调整数据，食管裂孔疝与任何长度的 BE 风险增加显著相关（OR = 3.91，95% CI = 3.31-4.62，p I² = 77%；p p = 0.014），这可能是导致异质性的一个潜在因素。根据 14 项研究的调整数据，这种正相关性依然存在（aOR = 3.26，95% CI = 2.44-4.35，p I² = 65%；p p I² = 78%；p p I² = 30%；p = 0.201）：结论：食管裂孔疝应该是BE，尤其是LSBE的重要风险因素：PROSPERO注册号：CRD42022367376。
Association between hiatal hernia and Barrett's esophagus: an updated meta-analysis with trial sequential analysis.
Background: Barrett's esophagus (BE) is a precursor of esophageal adenocarcinoma. It is critical to recognize the risk factors associated with BE.
Objectives: The present meta-analysis aims to systematically estimate the association of hiatal hernia with the risk of BE.
Design: A meta-analysis with trial sequential analysis.
Data sources and methods: The PubMed, EMBASE, and Cochrane Library databases were searched. The pooled odds ratios (ORs) and adjusted ORs (aORs) with their 95% confidence intervals (CIs) were calculated for the combined estimation of unadjusted data and data adjusted for confounders, respectively. Heterogeneity was quantified using the Cochrane Q test and I² statistics. Subgroup, meta-regression, and leave-one-out sensitivity analyses were employed to explore the sources of heterogeneity.
Results: Forty-seven studies with 131,517 participants were included. Based on the unadjusted data from 47 studies, hiatal hernia was significantly associated with an increased risk of any length BE (OR = 3.91, 95% CI = 3.31-4.62, p < 0.001). The heterogeneity was significant (I² = 77%; p < 0.001) and the definition of controls (p = 0.014) might be a potential contributor to heterogeneity. Based on the adjusted data from 14 studies, this positive association remained (aOR = 3.26, 95% CI = 2.44-4.35, p < 0.001). The heterogeneity was also significant (I² = 65%; p < 0.001). Meta-analysis of seven studies demonstrated that hiatal hernia was significantly associated with an increased risk of long-segment BE (LSBE) (OR = 10.01, 95% CI = 4.16-24.06, p < 0.001). The heterogeneity was significant (I² = 78%; p < 0.001). Meta-analysis of seven studies also demonstrated that hiatal hernia was significantly associated with an increased risk of short-segment BE (OR = 2.76, 95% CI = 2.05-3.71, p < 0.001). The heterogeneity was not significant (I² = 30%; p = 0.201).
Conclusion: Hiatal hernia should be a significant risk factor for BE, especially LSBE.
Registration: PROSPERO registration number CRD42022367376.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
