期刊
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
卷 147, 期 9, 页码 2681-2691出版社
SPRINGER
DOI: 10.1007/s00432-021-03544-3
关键词
Proton pump inhibitor; High-grade dysplasia; Esophageal adenocarcinoma; Barrett’ s esophagus; Meta-analysis
类别
The use of PPI is negatively associated with the risk of progression to HGD/EAC in BE patients, and the risk of HGD/EAC can be reduced with the prolonged use of PPI. Sensitivity analysis showed the stable results of this meta-analysis, and no publication bias was detected.
Purpose Previous research on the association between proton pump inhibitor (PPI) use and the risk of progression to high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC) in Barrett's Esophagus (BE) patients has generated inconsistent findings. This meta-analysis was performed to clarify the association. Methods We performed a comprehensive search strategy to select relevant studies up to September 2020. Heterogeneity was assessed using the I-squared statistic. Odds ratios (OR) and 95% confidence intervals (CI) were calculated through either fixed-effects or random-effects model. Duration-response was also performed to assess the gain effects of different PPI intake duration. Sensitivity analysis, subgroup analyses, and tests for publication bias or other small-study effects were conducted. Results Twelve studies with 155,769 subjects were included. The PPI use was associated with the reduced risk of BE progression to HGD/EAC (OR = 0.47, 95% CI = 0.32-0.71). In the duration-response analysis, the estimated OR for decreased risk of HGD/EAC with PPI intake duration of 12 months was 0.81 (95% CI = 0.71-0.91). Sensitivity analysis suggested the results of this meta-analysis were stable. No publication bias was detected. Conclusions PPI use is associated with a decreased risk of HGD/EAC in patients with BE. For further investigation, that more well-designed studies are still needed to elucidate the protective effect of PPI usage on BE patients to prevent HGD/EAC.
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