Brit J Cancer:抗生素使用与结直肠癌风险的关系

2020-09-25 MedSci原创 MedSci原创

抗生素使用与CRC风险之间的相关性在广谱和窄谱抗生素之间似乎有所不同。尚不清楚这种关联是否具有因果关系,需要更多的机制研究进一步阐明药物与微生物组之间的相互作用。

尚未有研究报道口服抗生素结直肠癌(CRC)之间的相关关系随抗生素谱和结直肠癌类型而变化,以及是否存在非线性的剂量依赖性关系。

近日,肿瘤领域权威杂志British Journal of Cancer上发表了一篇研究文章,研究人员检索了三个电子数据库和一个试验平台中所有相关研究,检索时间从数据库成立到2020年2月,且没有任何限制。随机效应荟萃分析得到了具有95%置信区间(CI)的合并效应量(ES)。剂量-反应建模分析了抗生素暴露天数与CRC风险之间的关系,并扩展到非线性多变量随机效应模型。

在6483项已发表的文献中,有十项研究符合纳入条件,包括410万受试者和73550多名CRC儿童。曾经使用过抗生素的人群合并CRC风险增加(ES=1.17,95%CI为1.05-1.30),特别是对于使用广谱抗生素人群(ES=1.70,95%CI为1.26-2.30),但对于窄谱抗生素人群则没有(ES=1.11,95%CI为0.93-1.32)。剂量反应分析没有提供任何特定剂量反应关联的有力证据,并且结肠癌和直肠癌的风险模式非常相似。

由此可见,抗生素使用与CRC风险之间的相关性在广谱和窄谱抗生素之间似乎有所不同。尚不清楚这种关联是否具有因果关系,需要更多的机制研究进一步阐明药物与微生物组之间的相互作用。

原始出处:

Johanna Simin.et al.Antibiotic use and risk of colorectal cancer: a systematic review and dose–response meta-analysis.British Journal of Cancer.2020.https://www.nature.com/articles/s41416-020-01082-2

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