Xian-Tao Zeng

Fruits and vegetables intake and risk of bladder cancer: a PRISMA-compliant systematic review and dose-response meta-analysis of prospective cohort studies.

AbstractClinical practice recommends eating ≥2.5 cups of fruits and vegetables (FVs) each day for cancer prevention, in which the evidence from epidemiological studies for the association between FVs intake and bladder cancer (BC) prevention is inconsistent.We searched the PubMed, Embase, and Willy online Library for relevant studies published up to September 27, 2014. Prospective cohort studies investigated FVs intake, and the risk of BC with ≥3 categories of exposure was included. A dose-response meta-analysis was carried out to evaluate the association between FVs intake and risk of BC.Fourteen cohorts with 17 studies including 9447 cases were identified. No evidence of nonlinear association was examined between FVs intake and risk of BC. The summarized relevant risk (RR) of every 0.2 serving increment a day was 1.00 (95%CI: 0.99, 1.00; P = 0.17; I2 = 41.7%; n = 14) for total fruits; 0.99 (95%CI: 0.96, 1.01; P = 0.28; I2 = 37.0%; n = 13) for total vegetables; and 0.99 (95%CI: 0.97, 1.01; P = 0.24; I2 = 57.5%; n = 8) for both FVs. In further analysis, we observed inverse association between every 0.2 serving increment of green leafy vegetables intake a day and risk of BC (RR = 0.98, 95%CI: 0.96, 0.99; I2 = 0.0%; P < 0.01; Power = 0.76; n = 6), but neither for cruciferous vegetables (RR = 0.97, 95%CI: 0.93, 1.01; P = 0.19; I2 = 55.8%; n = 8) nor for citrus (RR = 1.00, 95%CI: 1.00, 1.00; P = 0.83; I2 = 0.0%; n = 7). Subgroup analysis showed consistent results.Little evidence supports a beneficial effect for total fruits, vegetables, both FVs, and citrus intake against bladder cancer. Green leafy vegetables may help prevent bladder cancer.

Periodontal Disease and Risk of Head and Neck Cancer: A Meta-Analysis of Observational Studies

Background Many epidemiological studies have found a positive association of periodontal disease (PD) with risk of head and neck cancer (HNC), but the findings are varied or even contradictory. In this work, we performed a meta-analysis to ascertain the relationship between PD and HNC risk. Methods We searched the PubMed, Embase, and Cochrane Library databases for relevant observational studies on the association between PD and HNC risk published up to March 23, 2013. Data from the included studies were extracted and analyzed independently by two authors. Meta-analysis was performed using RevMan 5.2 software. Results We obtained seven observational studies involving two cohort and six case-control studies. Random-effects meta-analysis indicated a significant association between PD and HNC risk (odds ratio = 2.63, 95% confidence interval = 1.1.68 - 4.14; p < 0.001), with sensitivity analysis showing that the result was robust. Subgroup analyses based on adjustment for covariates, study design, PD assessment, tumor site, and ethnicity also revealed a significant association. Conclusions Based on currently evidence, PD is probably a significant and independent risk factor of HNC.

Holmium Laser Enucleation versus Transurethral Resection in Patients with Benign Prostate Hyperplasia: An Updated Systematic Review with Meta-Analysis and Trial Sequential Analysis

Background Holmium laser enucleation (HoLEP) in surgical treatment of benign prostate hyperplasia (BPH) potentially offers advantages over transurethral resection of the prostate (TURP). Methods Published randomized controlled trials (RCTs) were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Library up to October 10, 2013 (updated on February 5, 2014). After methodological quality assessment and data extraction, meta-analysis was performed using STATA 12.0 and Trial Sequential Analysis (TSA) 0.9 software. Results Fifteen studies including 8 RCTs involving 855 patients met the criteria. The results of meta-analysis showed that: a) efficacy indicators: there was no significant difference in quality of life between the two groups (P>0.05), but compared with the TURP group, Qmax was better at 3 months and 12 months, PVR was less at 6, 12 months, and IPSS was lower at 12 months in the HoLEP, b) safety indicators: compared with the TURP, HoLEP had less blood transfusion (RR 0.17, 95% CI 0.06 to 0.47), but there was no significant difference in early and late postoperative complications (P>0.05), and c) perioperative indicators: HoLEP was associated with longer operation time (WMD 14.19 min, 95% CI 6.30 to 22.08 min), shorter catheterization time (WMD −19.97 h, 95% CI −24.24 to −15.70 h) and hospital stay (WMD −25.25 h, 95% CI −29.81 to −20.68 h). Conclusions In conventional meta-analyses, there is no clinically relevant difference in early and late postoperative complications between the two techniques, but HoLEP is preferable due to advantage in the curative effect, less blood transfusion rate, shorter catheterization duration time and hospital stay. However, trial sequential analysis does not allow us to draw any solid conclusion in overall clinical benefit comparison between the two approaches. Further large, well-designed, multicentre/international RCTs with long-term data and the comparison between the two approaches remain open.

Periodontal disease and risk of coronary heart disease: An updated meta-analysis of prospective cohort studies

a Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China b Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China c Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China d Department of Cardiology, Suizhou Hospital, Hubei University of Medicine, Suizhou 441300, China

Meta-Analysis of Association Between Interleukin-1β C-511T Polymorphism and Chronic Periodontitis Susceptibility.

BACKGROUND Many studies have been conducted to explore the association between interleukin (IL)-1β C-511T polymorphism and risk of chronic periodontitis (CP) but with different or even contradictory results. A meta-analysis was performed to further explore their association. METHODS PubMed, Chinese National Knowledge Infrastructure, and EMBASE were searched up to September 30, 2014 for relevant case-control studies. Two authors (D-YL and L-YX) independently selected studies and extracted data from included studies. The meta-analysis was performed using comprehensive meta-analysis software. RESULTS Nineteen case-control studies involving 2,173 patients with CP and 3,900 healthy controls were included. Using a random-effects meta-analysis model, a non-significant association between IL-1β C-511T polymorphism and CP was identified (T versus C: odds ratio [OR] = 1.03, 95% confidence interval [CI] = 0.85 to 1.25; TT versus CC: OR = 1.03, 95% CI = 0.72 to 1.46; CT versus CC: OR = 0.96, 95% CI = 0.71 to 1.30; CT + TT versus CC: OR = 1.00, 95% CI = 0.74 to 1.34; TT versus CT + CC: OR = 1.05, 95% CI = 0.81 to 1.38), and sensitivity analysis indicated that the results were robust. Subgroup analyses also revealed a non-significant association. No publication bias was detected. CONCLUSIONS Based on currently available evidence, IL-1β C-511T polymorphism is not associated with the risk of developing CP. Additional research is warranted to further explore and confirm the association of genetic polymorphism and CP.

Association Between Interleukin-4 Gene −590 C/T, −33 C/T, and 70-Base-Pair Polymorphisms and Periodontitis Susceptibility: A Meta-Analysis

BACKGROUND Several studies have investigated the association between interleukin (IL)-4 gene -590 C/T, -33 C/T, or 70-base pair (70-bp) polymorphisms and periodontitis susceptibility but with conflicting results. Hence, a meta-analysis was conducted to explore whether these polymorphisms are associated with periodontitis susceptibility. METHODS A comprehensive literature search was conducted of PubMed, Embase, Scopus, ScienceDirect, and Web of Science up to April 5, 2014. After the eligible studies were identified, data were extracted and quality-assessed before performing the meta-analysis. RESULTS The meta-analysis included 23 eligible case-control studies from 11 articles involving 12 studies of the -590 C/T polymorphism (1,220 cases and 2,039 controls), five of the -33 C/T polymorphism (715 cases and 967 controls), and four of the 70-bp polymorphism (426 cases and 506 controls). The meta-analysis showed that none of these IL-4 gene polymorphisms were significantly associated with periodontitis susceptibility in all study participants. However, subgroup analysis showed that the IL-4 -590 T allele (odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.02 to 1.42, P = 0.03) and TT genotype (OR = 1.68, 95% CI = 1.05 to 2.67, P = 0.03) were associated with periodontitis in whites. CONCLUSIONS Based on current evidence, the IL-4 -33 C/T and 70-bp polymorphisms were not associated with an increased risk of periodontitis. However, the IL-4 -590 T allele and TT genotype were associated with increased risk of periodontitis in whites.

Periodontal Disease and Incident Lung Cancer Risk: A Meta-Analysis of Cohort Studies.

BACKGROUND Periodontal disease is linked to a number of systemic diseases such as cardiovascular diseases and diabetes mellitus. Recent evidence has suggested periodontal disease might be associated with lung cancer. However, their precise relationship is yet to be explored. Hence, this study aims to investigate the association of periodontal disease and risk of incident lung cancer using a meta-analytic approach. METHODS PubMed, Scopus, and ScienceDirect were searched up to June 10, 2015. Cohort and nested case-control studies investigating risk of lung cancer in patients with periodontal disease were included. Hazard ratios (HRs) were calculated, as were their 95% confidence intervals (CIs) using a fixed-effect inverse-variance model. Statistical heterogeneity was explored using the Q test as well as the I(2) statistic. Publication bias was assessed by visual inspection of funnel plots symmetry and Eggers test. RESULTS Five cohort studies were included, involving 321,420 participants in this meta-analysis. Summary estimates based on adjusted data showed that periodontal disease was associated with a significant risk of lung cancer (HR = 1.24, 95% CI = 1.13 to 1.36; I(2) = 30%). No publication bias was detected. Subgroup analysis indicated that the association of periodontal disease and lung cancer remained significant in the female population. CONCLUSION Evidence from cohort studies suggests that patients with periodontal disease are at increased risk of developing lung cancer.

Fat Intake Is Not Linked to Prostate Cancer: A Systematic Review and Dose-Response Meta-Analysis

Background Since the late 1960s, the average global supply of fat has increased by 20 g per capita per day. While fat intake has been considered a potential risk factor for prostate cancer (Pca), the hypothesis from previous epidemiologic studies remained equivocal. Materials and Methods Relevant cohort studies were identified through a literature search in PubMed, ScienceDirect and Wiley Online Library up to March 1, 2015. A systematic review and dose-response meta-analysis were used to assess the relationship between fat intake and the risk for Pca. Results We identified 14 cohort studies, which included 37,349 cases and a total of 751,030 participants. We found no evidence of a non-linear association between fat intake and the risk for Pca. Overall, the summarized relative risks for every 28.35 g increment a day was 0.99 (95%CI: 0.98, 1.01; P=0.94; n=13) for total fat intake, 1.00 (95%CI: 1.00, 1.00; P=0.72; n=9) for saturated fat, 0.99 (95%CI: 0.95, 1.03; P=0.55; n=7) for polyunsaturated fat, and 1.00 (95%CI: 0.95, 1.04; P=0.85; n=8) for monounsaturated fat. Additionally, there was no link to the risk for advanced stage Pca regarding total fat intake (RR=1.02, 95%CI: 0.96, 1.08; P=0.63; n=5), saturated fat (RR=0.96, 95%CI: 0.84, 1.11; P=0.61; n=6), polyunsaturated fat (RR=0.96, 95%CI: 0.79, 1.17; P=0.68; n=6), or monounsaturated fat (RR=0.96, 95%CI: 0.86, 1.07; P=0.42; n=6). Subgroup and sensitively analyses showed consistent results. Conclusion Little evidence from published cohort studies supports the statement that total fat, saturated fat or unsaturated fat intake increases the risk for Pca or advanced stage Pca.

Association between the TP53 codon 72 polymorphism and risk of oral squamous cell carcinoma in Asians: a meta-analysis

BackgroundSeveral epidemiological studies have previously investigated the association between the TP53 codon 72 polymorphism and oral squamous cell carcinoma (OSCC) susceptibility; however, current results are inconsistent. We therefore performed this meta-analysis to thoroughly investigate any association among Asian patients.MethodsA comprehensive search of PubMed and Embase databases was performed up to December 2013. We only considered studies consisting of patients diagnosed with OSCC by pathological methods. Statistical analyses were performed using Review Manager (RevMan) 5.2 software and odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association.ResultsA total of 11 case–control studies involving 2,298 OSCC patients and 2,111 controls were included. We found no association between the TP53 codon 72 polymorphism and OSCC susceptibility [(OR = 0.77, 95% CI = 0.48–1.22) for Arg vs. Pro; (OR = 0.67, 95% CI = 0.31–1.43) ArgArg vs. ProPro; (OR = 1.14, 95% CI = 0.97–1.35) ArgPro vs. ProPro; (OR = 0.85, 95% CI = 0.53–1.34) (ArgPro + ArgArg) vs. ProPro; or (OR = 0.34, 95% CI = 0.34–1.23) for ArgArg vs. (ProPro + ArgPro)]. However, subgroup analysis demonstrated an association between the TP53 codon 72 polymorphism and human papillomavirus (HPV)-related OSCC patients. Although statistical heterogeneity was detected, there was no evidence of publication bias.ConclusionsCurrent results suggest that the TP53 codon 72 polymorphism is not associated with OSCC in Asians without the presence of HPV infection. Further research is necessary to determine if such a relationship exists in HPV-related OSCC patients.

Tooth Loss and Head and Neck Cancer: A Meta-Analysis of Observational Studies

Backgroud Epidemiological studies have shown that tooth loss is associated with risk of head and neck cancer (HNC); however, the results were inconsistent. Therefore, we conducted a meta-analysis to ascertain the relationship between tooth loss and HNC. Methods We searched for relevant observational studies that tested the association between tooth loss and risk of HNC from PubMed and were conducted up to January 30, 2013. Data from the eligible studies were independently extracted by two authors. The meta-analysis was performed using the Comprehensive Meta-Analysis 2.2 software. Sensitivity and subgroup analyses were conducted to evaluate the influence of various inclusions. Publication bias was also detected. Results Ten articles involving one cohort and ten case-control studies were yielded. Based on random-effects meta-analysis, an association between tooth loss and HNC risk was identified [increased risk of 29% for 1 to 6 teeth loss (OR = 1.29, 95% CI = 0.52–3.20, p = 0.59), 58% for 6 to 15 teeth loss (OR = 1.58, 95% CI = 1.08–2.32, p = 0.02), 63% for 11+ teeth loss (OR = 1.63, 95% CI = 1.23–2.14, p<0.001), 72% for 15+ teeth loss (OR = 1.72, 95% CI = 1.26–2.36, p<0.001), and 89% for 20+ teeth loss (OR = 1.89, 95% CI = 1.27–2.80, p<0.001)]. The sensitivity analysis shows that the result was robust, and publication bias was not detected. Conclusions Based on the current evidence, tooth loss is probably a significant and dependent risk factor of HNC, which may have a dose-response effect. People who lost six or more teeth should pay attention to symptoms of HNC, and losing 11 teeth or 15 teeth may be the threshold.