轮班工作与结直肠癌关系的Meta分析
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摘要
目的:系统性评价轮班工作与结直肠癌发生的相关性。方法:计算机检索Web of Science、PubMed、Cochrane Library、EMbase,以及中国知网、万方和维普数据库,搜集从建库至2018年9月关于轮班工作与结直肠癌发生风险的相关研究,并手动检索纳入研究的参考文献。对符合纳入标准的研究进行资料提取,用纽卡斯尔-渥太华量表对文献进行质量评价,然后采用STATA 12.0软件进行Meta分析。结果:共纳入4篇病例-对照研究,5篇队列研究。Meta分析结果表明,轮班工作会增加结直肠癌的发病风险[相对危险度(relative risk,RR)=1.180,95%可信区间(condence interval,CI)为1.060～1.300,P <0.001]。亚组分析结果表明,高纬度地区轮班职业人群罹患结直肠癌的风险(RR=1.255,95%CI为1.021～1.544,P <0.05)高于中低纬度地区,轮班工作发生直肠癌的风险(RR=1.277,95%CI为1.040～1.570,P <0.001)高于结肠癌,轮班年限超过15年的人群患结直肠癌的风险(RR=1.234,95%CI为1.069～1.425,P=0.002)高于从未轮班的人群。结论:轮班工作与结直肠癌的发生相关,且直肠癌的患病风险高于结肠癌;高纬度地区轮班职业人群的结直肠癌患病风险高于中低纬度地区。
Objective: To systematically evaluate the association between shift work and the incidence of colorectal cancer.Methods: A computer-based search was conducted to collect the studies related to the relationship between shift work and the risk of colorectal cancer in Web of Science, PubMed, Cochrane Library,EMbase, China National Knowledge Internet, Wanfang database and VIP Periodical Resource Integration Service Platform from the inception to September 2018. The corresponding references of the included studies were searched manually. The data were extracted from the included studies which met the inclusion criteria. TheNewcastle-Ottawa Scale was used to evaluate the quality of literatures, and then the Metaanalysis was performed by using STATA 12.0 software.Results: A total of 4 case-control studies and 5 cohort studies were included. The Metaanalysis showed that shift work would increase the risk of colorectal cancer [relative risk(RR) = 1.180, 95% confidence interval(CI): 1.060-1.300, P < 0.001]. The subgroup analysis showed that the risk of colorectal cancer in the shift workers in high latitudes was higher than that in middle and low latitudes(RR = 1.255,95% CI : 1.021-1.544, P < 0.05), the risk of rectal cancer in the shift workers was higher than the risk of colon cancer(RR = 1.277,95% CI : 1.040-1.570, P < 0.001), and the risk of colorectal cancer in the shift workers who had been on shifts for more than 15 years was higher than that in the workers who had never been of shift(RR = 1.234, 95% CI : 1.069-1.425, P = 0.002).Conclusion: Shift work is associated with the onset of colorectal cancer, and the risk of rectal cancer is higher than that of colon cancer. The risk of colorectal cancer in the shift workers in high latitudes is higher than that in middle and low latitudes.
Objective: To systematically evaluate the association between shift work and the incidence of colorectal cancer.Methods: A computer-based search was conducted to collect the studies related to the relationship between shift work and the risk of colorectal cancer in Web of Science, PubMed, Cochrane Library,EMbase, China National Knowledge Internet, Wanfang database and VIP Periodical Resource Integration Service Platform from the inception to September 2018. The corresponding references of the included studies were searched manually. The data were extracted from the included studies which met the inclusion criteria. TheNewcastle-Ottawa Scale was used to evaluate the quality of literatures, and then the Metaanalysis was performed by using STATA 12.0 software.Results: A total of 4 case-control studies and 5 cohort studies were included. The Metaanalysis showed that shift work would increase the risk of colorectal cancer [relative risk(RR) = 1.180, 95% confidence interval(CI): 1.060-1.300, P < 0.001]. The subgroup analysis showed that the risk of colorectal cancer in the shift workers in high latitudes was higher than that in middle and low latitudes(RR = 1.255,95% CI : 1.021-1.544, P < 0.05), the risk of rectal cancer in the shift workers was higher than the risk of colon cancer(RR = 1.277,95% CI : 1.040-1.570, P < 0.001), and the risk of colorectal cancer in the shift workers who had been on shifts for more than 15 years was higher than that in the workers who had never been of shift(RR = 1.234, 95% CI : 1.069-1.425, P = 0.002).Conclusion: Shift work is associated with the onset of colorectal cancer, and the risk of rectal cancer is higher than that of colon cancer. The risk of colorectal cancer in the shift workers in high latitudes is higher than that in middle and low latitudes.
引文
[1]WALASA WM,CAREY RN,SI S,et al Association between shiftwork and the risk of colorectal cancer in females:a population-based case-control study[J].Occup Environ Med,2018,75(5):344-350.
[2]WILLIAMS CD,GRADY WM,ZULLIG LL.Use of NCCN guidelines,other guidelines,and biomarkers for colorectal cancer screening[J].J Natl Compr Canc Netw,2016,14(11):1479-1485.
[3]司怡然,邓婷,巴一.糖尿病与结直肠癌患者预后相关的研究进展[J].肿瘤,2017,37(4):427-432.
[4]陈奕杰,方瑞,杜军.小鼠结直肠癌模型及其体内示踪技术研究进展[J].肿瘤,2015,35(1):104-110.
[5]王洋,刘珊,蒋永新.结直肠癌放化疗抵抗功能及机制的研究进展[J].肿瘤,2017,37(7):795-800.
[6]RAMIN C,DEVORE EE,WANG W,et al.Night shift work at specific age ranges and chronic disease risk factors[J].Occup Environ Med,2015,72(2):100-107.
[7]STRAIF K,BAAN R,GROSSE Y,et al.Carcinogeni city of shift-work,painting,and fire-fighting[J].Lancet Oncol,2007,8(12):1065-1066.
[8]SCHWARTZBAUM J,AHLBOM A,FEYCHTING M.Cohort study of cancer risk among male and female shift workers[J].Scand J Work Environ Health,2007,33(5):336-343.
[9]PAPANTONIOU K,DEVORE EE,MASSA J,et al.Rotating night shift work and colorectal cancer risk in the nurses’health studies[J].Int J Cancer,2018,143(11):2709-2717.
[10]PAPANTONIOU K,CASTA-VINYALS G,ESPINOSA A,et al.Shift work and colorectal cancer risk in the MCCSpain case-control study[J].Scand J Work Envi r o n He a l t h,2017,43(3):250-259.
[11]TYNES T,HANNEVIK M,ANDERSEN A,et al.Incidence of breast cancer in Norwegian female radio and telegraph operators[J].Cancer Causes Control,1996,7(2):197-204.
[12]PARENT ME,EL-ZEIN M,ROUSSEAU MC,et al.Night work and the risk of cancer among men[J].Am J Epidemiol,2012,176(9):751-759.
[13]SCHERNHAMMER ES,LADEN F,SPEIZERFE,et al.Night-shift work and risk of colorectal cancer in the nurses’health study[J].J Natl Cancer Inst,2003,95(11):825-828.
[14]DEVORE EE,MASSA J,PAPANTONIOU K,et al.Rotating night shift work,sleep,and colorectal adenoma in women[J].Int J Colorectal Dis,2017,32(7):1013-1018.
[15]TSAI RJ,LUCKHAUPT SE,SWEENEY MH,et al.Shift work and cancer screening:do females who work alternative shifts undergo recommended cancer screening?[J].Am J Ind Med,2014,57(3):265-275.
[16]于鑫,张永镇,于恩达,等.结直肠癌患者维生素D受体对血浆促炎性细胞因子和肠道菌群的影响[J].中国肿瘤,2018,27(5):382-386.
[17]WANG X,JI A,ZHU Y,et al.A metaanalysis including dose-response relationship between night shift work and the risk of colorectal c a n c e r[J].O n c o t a r g e t,2015,6(28):25046-25060.
[18]WICKREMARATNE K,ZHAO I,STRAND H.Rotating shift work and colorectal cancer among nurses and midwives:a cross-sectional study[J].Aust J Adv Nurs,2017,34(4):6-15.
[19]SIMONS-LINARES CR,JAISWAL P,ATTARBM,et al.Are night-shift workers at an increased risk for colonic adenomas?[J].Am J Gastroenterol,2017,112:S153.
[20]GRANT WB.An ecological study of cancer incidence and mortality rates in France with respect to latitude,an index for vitamin D production[J].Dermatoendocrinol,2010,2(2):62-67.
[21]PAUL MA,LOVE RJ,HAWTON A,et al.Sleep and the endogenous melatonin rhythm of high arctic residents during the summer and winter[J].Physiol Behav,2015,141:199-206.
[22]NATHAN PJ,WYNDHAM EL,BURROWS GD,et al.The effect of gender on the melatonin suppression by light:a dose response relationship[J].J Neural Transm(Vienna),2000,107(3):271-279.
[23]BLASK DE,DAUCHY RT,SAUER LA,et al.Oral melatonin supplementation in rats and a human subject suppresses the growth activity of steroid receptor negative human breast cancer xenografts in female nude rats via an MT1 receptor-mediated suppression of signal tranduction and linoleic acid uptake and metabolism[J].Cancer Res,2005,65(9):1358.
[24]BLASK DE,HILL SM,DAUCHY RT,et al.Circadian regulation of molecular,dietary,and metabolic signaling mechanisms of human breast cancer growth by the nocturnal melatonin signal and the consequences of its disruption by light at night[J].J Pineal Res,2011,51(3):259-269.
[25]王雪竹,孙铮.褪黑素受体及其介导的抗肿瘤机制研究进展[J].中国细胞生物学学报,2017,39(4):481-487.
[26]GARCIA CP,LAMARQUE AL,COMBA A,et al.Synergistic anti-tumor effects of melatonin and PUFAs from walnuts in a murine mammary adenocarcinoma model[J].Nutrition,2015,31(4):570-577.
[27]LI W,FAN M,CHEN Y,et al.Melatonin induces cell apoptosis in AGS cells through the activation of JNK and P38 MAPK and the suppression of nuclear factor-kappa B:a novel therapeutic implication for gastric cancer[J].Cell Physiol Biochem,2015,37(6):2323-2338.
[2]WILLIAMS CD,GRADY WM,ZULLIG LL.Use of NCCN guidelines,other guidelines,and biomarkers for colorectal cancer screening[J].J Natl Compr Canc Netw,2016,14(11):1479-1485.
[3]司怡然,邓婷,巴一.糖尿病与结直肠癌患者预后相关的研究进展[J].肿瘤,2017,37(4):427-432.
[4]陈奕杰,方瑞,杜军.小鼠结直肠癌模型及其体内示踪技术研究进展[J].肿瘤,2015,35(1):104-110.
[5]王洋,刘珊,蒋永新.结直肠癌放化疗抵抗功能及机制的研究进展[J].肿瘤,2017,37(7):795-800.
[6]RAMIN C,DEVORE EE,WANG W,et al.Night shift work at specific age ranges and chronic disease risk factors[J].Occup Environ Med,2015,72(2):100-107.
[7]STRAIF K,BAAN R,GROSSE Y,et al.Carcinogeni city of shift-work,painting,and fire-fighting[J].Lancet Oncol,2007,8(12):1065-1066.
[8]SCHWARTZBAUM J,AHLBOM A,FEYCHTING M.Cohort study of cancer risk among male and female shift workers[J].Scand J Work Environ Health,2007,33(5):336-343.
[9]PAPANTONIOU K,DEVORE EE,MASSA J,et al.Rotating night shift work and colorectal cancer risk in the nurses’health studies[J].Int J Cancer,2018,143(11):2709-2717.
[10]PAPANTONIOU K,CASTA-VINYALS G,ESPINOSA A,et al.Shift work and colorectal cancer risk in the MCCSpain case-control study[J].Scand J Work Envi r o n He a l t h,2017,43(3):250-259.
[11]TYNES T,HANNEVIK M,ANDERSEN A,et al.Incidence of breast cancer in Norwegian female radio and telegraph operators[J].Cancer Causes Control,1996,7(2):197-204.
[12]PARENT ME,EL-ZEIN M,ROUSSEAU MC,et al.Night work and the risk of cancer among men[J].Am J Epidemiol,2012,176(9):751-759.
[13]SCHERNHAMMER ES,LADEN F,SPEIZERFE,et al.Night-shift work and risk of colorectal cancer in the nurses’health study[J].J Natl Cancer Inst,2003,95(11):825-828.
[14]DEVORE EE,MASSA J,PAPANTONIOU K,et al.Rotating night shift work,sleep,and colorectal adenoma in women[J].Int J Colorectal Dis,2017,32(7):1013-1018.
[15]TSAI RJ,LUCKHAUPT SE,SWEENEY MH,et al.Shift work and cancer screening:do females who work alternative shifts undergo recommended cancer screening?[J].Am J Ind Med,2014,57(3):265-275.
[16]于鑫,张永镇,于恩达,等.结直肠癌患者维生素D受体对血浆促炎性细胞因子和肠道菌群的影响[J].中国肿瘤,2018,27(5):382-386.
[17]WANG X,JI A,ZHU Y,et al.A metaanalysis including dose-response relationship between night shift work and the risk of colorectal c a n c e r[J].O n c o t a r g e t,2015,6(28):25046-25060.
[18]WICKREMARATNE K,ZHAO I,STRAND H.Rotating shift work and colorectal cancer among nurses and midwives:a cross-sectional study[J].Aust J Adv Nurs,2017,34(4):6-15.
[19]SIMONS-LINARES CR,JAISWAL P,ATTARBM,et al.Are night-shift workers at an increased risk for colonic adenomas?[J].Am J Gastroenterol,2017,112:S153.
[20]GRANT WB.An ecological study of cancer incidence and mortality rates in France with respect to latitude,an index for vitamin D production[J].Dermatoendocrinol,2010,2(2):62-67.
[21]PAUL MA,LOVE RJ,HAWTON A,et al.Sleep and the endogenous melatonin rhythm of high arctic residents during the summer and winter[J].Physiol Behav,2015,141:199-206.
[22]NATHAN PJ,WYNDHAM EL,BURROWS GD,et al.The effect of gender on the melatonin suppression by light:a dose response relationship[J].J Neural Transm(Vienna),2000,107(3):271-279.
[23]BLASK DE,DAUCHY RT,SAUER LA,et al.Oral melatonin supplementation in rats and a human subject suppresses the growth activity of steroid receptor negative human breast cancer xenografts in female nude rats via an MT1 receptor-mediated suppression of signal tranduction and linoleic acid uptake and metabolism[J].Cancer Res,2005,65(9):1358.
[24]BLASK DE,HILL SM,DAUCHY RT,et al.Circadian regulation of molecular,dietary,and metabolic signaling mechanisms of human breast cancer growth by the nocturnal melatonin signal and the consequences of its disruption by light at night[J].J Pineal Res,2011,51(3):259-269.
[25]王雪竹,孙铮.褪黑素受体及其介导的抗肿瘤机制研究进展[J].中国细胞生物学学报,2017,39(4):481-487.
[26]GARCIA CP,LAMARQUE AL,COMBA A,et al.Synergistic anti-tumor effects of melatonin and PUFAs from walnuts in a murine mammary adenocarcinoma model[J].Nutrition,2015,31(4):570-577.
[27]LI W,FAN M,CHEN Y,et al.Melatonin induces cell apoptosis in AGS cells through the activation of JNK and P38 MAPK and the suppression of nuclear factor-kappa B:a novel therapeutic implication for gastric cancer[J].Cell Physiol Biochem,2015,37(6):2323-2338.