Zhanwei Zhao

Association Between Consumption of Red and Processed Meat and Pancreatic Cancer Risk: A Systematic Review and Meta-analysis

BACKGROUND & AIMS The relationship between consumption of red and processed meat and pancreatic cancer risk is inconclusive. We conducted a systematic review and meta‐analysis to analyze this relationship. METHODS We performed a systematic search of PubMed, EMBASE, and the Web of Science to identify studies that examined associations between consumption of different kinds of meat with pancreatic cancer and were published through February 2016. By using data from these articles, we associated level of consumption with cancer risk and performed subgroup, meta‐regression, and publication bias analyses. RESULTS We collected and analyzed data from a total of 28 studies that involved 3,143,777 participants (11,325 consumers of red meat) and 2,904,866 participants (9955 consumers of processed meat). We observed statistically significant differences between consumers and non‐consumers of these meats in case‐control studies (red meat, P = .02; processed meat, P < .01) but not in cohort studies (red meat, P = .09; processed meat, P = .18). In cohort studies, a 100 g/day increase in red meat consumption was associated with significant increase in risk of pancreatic cancer (P = .01); a 50 g/day increase in processed meat consumption was not associated with significant increase in risk of pancreatic cancer (P = .90). In cohort studies, we observed associations in consumption of red meat by men and pancreatic cancer (P < .01) and consumption of processed meat by men and pancreatic cancer (P < .01) but no associations for women (red meat, P = .61; processed meat, P = .88). CONCLUSIONS In a systematic review and meta‐analysis, we found case‐control but not cohort studies to associate consumption of red and processed meat with risk of pancreatic cancer. However, in cohort studies, consumption of red and processed meat appeared to increase risk of pancreatic cancer in men but not in women.

Red and processed meat consumption and colorectal cancer risk: a systematic review and meta-analysis

The associations between red and processed meat consumption and the risk of colorectal cancer types have not been conclusively defined. We performed a systematic review and meta-analysis to analyze these associations. We searched PubMed and EMBASE to identify studies published from inception through September 2016. Dose-response, subgroup and subtype analyses of colorectal cancer (colon cancer, proximal colon cancer, distal colon cancer and rectal cancer) were performed. We ultimately selected 60 eligible studies. Positive associations were observed for colorectal cancer in case-control studies (red meat, P<0.01; processed meat, P<0.01) and cohort studies (red meat, P<0.01; processed meat, P<0.01). However, subtype analyses yielded null results for distal colon cancer in case-control studies (P=0.41) and cohort studies (P=0.18) for red meat and null results for proximal colon cancer in case-control studies (P=0.13) and cohort studies (P=0.39) for processed meat. Additionally, although the results of case-control studies were positive (red meat, P<0.01; processed meat, P=0.04) for rectal cancer, there were no positive associations between red (P=0.34) and processed meat (P=0.06) consumption and the risk in cohort studies. In a systematic review and meta-analysis, we found consumption of red and processed meat was associated with the risk of overall colorectal cancer but not rectal cancer. Additionally, there were no associations between the consumption of red meat and distal colon cancer risk and between the consumption of processed meat and proximal colon cancer risk.

Meta-analysis: The diagnostic efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions.

Chromoendoscopy (CE) is widely used in the diagnosis of early gastric cancer (EGC) and premalignant gastric lesions (PGLs). We conducted a meta‐analysis to evaluate the diagnostic efficacy of CE for EGC and PGLs.

Regulatory B10 cells play a protective role in severe acute pancreatitis

BackgroundB10 cells are specific B cell subsets with the capacity of producing IL-10 to inhibit immune responses. Several studies have demonstrated that B10 cells are correlated with some immune and inflammatory diseases, such as experimental autoimmune encephalomyelitis (EAE), collagen-induced arthritis (CA), colitis and contact hypersensitivity. However, its role in severe acute pancreatitis (SAP) has not been clearly demonstrated yet.PurposeIn this study, we show that B10 cells can inhibit inflammation of severe acute pancreatitis (SAP).Materials and methodsBlood from 17 patients with SAP and 22 age-matched healthy volunteers were collected to detect the proportion of B10 cells. CD19−/− mice were used as B10 cell-deficient mice. Amylase and lipase levels, pancreatic edema and HE staining were tested to assess the severity of SAP.ResultsCD19−/− mice, which lack B10 cells, suffered a more severe inflammation in pancreas compared with wild-type mice after caerulein injection. The frequency of B10 cells was decreased both in SAP patients and SAP animal models. Adoptive transfer of B10 cells ameliorates inflammatory injury of pancreatitis in CD19−/− mice.ConclusionThus, we identified B10 cells as a protective factor for SAP and provided a novel target for SAP treatment.

Hepatic steatosis depresses alpha-1-antitrypsin levels in human and rat acute pancreatitis

Hepatic steatosis (HS) can exacerbate acute pancreatitis (AP). This study aimed to investigate the relation between α1-antitrypsin (AAT) and acute pancreatitis when patients have HS. Using proteomic profiling, we identified 18 differently expressed proteins pots in the serum of rats with or without HS after surgical establishment of AP. AAT was found to be one of the significantly down-regulated proteins. AAT levels were significantly lower in hepatic steatosis acute pancreatitis (HSAP) than in non-HSAP (NHSAP) (P < 0.001). To explore the clinical significance of these observations, we measured the levels of AAT in the serum of 240 patients with HSAP, NHSAP, fatty liver disease (FLD), or no disease. Compared with healthy controls, serum AAT levels in patients with NHSAP were significantly higher (P < 0.01), while in patients with HSAP serum AAT levels were significantly lower (P < 0.01). Further studies showed that acute physiology and chronic health evaluation (APACHE-II) scores were negatively correlated with serum AAT levels (r = −0.85, P < 0.01). In conclusion, low serum levels of AAT in patients with HSAP are correlated with disease severity and AAT may represent a potential target for therapies aiming to improve pancreatitis.

Red and processed meat consumption and gastric cancer risk: a systematic review and meta-analysis

The associations between red and processed meat consumption and gastric cancer risk have remained inconclusive. We performed a systematic review and meta-analysis to analyze these associations. We searched PubMed and EMBASE to identify studies published from inception through October 2016. Subtype analyses of gastric cancer (gastric cardia adenocarcinoma and gastric non-cardiac adenocarcinoma) and dose-response analyses were performed. We finally selected 42 eligible studies. The summary relative risks of highest versus lowest consumption were positive for case-control studies with 1.67 (1.36-2.05) for red meat and 1.76 (1.51-2.05) for processed meat, but negative for cohort studies with 1.14 (0.97-1.34) for red meat and 1.23 (0.98-1.55) for processed meat. Subtype analyses of cohort studies suggested null results for gastric cardia adenocarcinoma (red meat, P = 0.79; processed meat, P = 0.89) and gastric non-cardiac adenocarcinoma (red meat, P = 0.12; processed meat, P = 0.12). In conclusion, the present analysis suggested null results between red and processed meat consumption and gastric cancer risk in cohort studies, although case-control studies yielded positive associations. Further well-designed prospective studies are needed to validate these findings.

Dietary fruit, vegetable, fat, and red and processed meat intakes and Barrett's esophagus risk: a systematic review and meta-analysis.

The relationships between dietary fruit, vegetable, fat, and red and processed meat intakes and Barrett’s esophagus (BE) risk remain inconclusive. We conducted a systematic review and meta-analysis to summarize the available evidence on these issues. PubMed, EMBASE and the Cochrane Library were searched for studies published from inception through October 2015. A total of eight studies were included in this analysis. Fruit intake was not associated with BE risk (OR = 0.65, 95% CI = 0.37–1.13), but vegetable intake was strongly associated with BE risk (OR = 0.45, 95% CI = 0.29–0.71). Saturated fat, red meat and processed meat intakes were not associated with BE risk with OR = 1.25 (95% CI = 0.82–1.91), OR = 0.85 (95% CI = 0.61–1.17) and OR = 1.03 (95% CI = 0.73–1.46), respectively. Dietary vegetable not fruits intake may be associated with decreased BE risk. Fat and red and processed meat intakes may not contribute to an increased BE risk. Well-designed, large prospective studies with better established dose-response relationships are needed to further validate these issues.

A systemic review and an updated meta-analysis: minimally invasive vs open pancreaticoduodenectomy

The feasible of minimally invasive pancreaticoduodenectomy (MIPD) remains controversial when compared with open pancreaticoduodenectomy (OPD). We conducted a systemic review and meta-analysis to summarise the available evidence to compare MIPD vs OPD. We systemically searched PubMed, EMBASE and Web of Science for studies published through February 2016. The primary endpoint was postoperative pancreatic fistula (POPF, grade B/C). A total of 27 studies involving 14,231 patients (2,377 MIPD and 11,854 OPD) were included. MIPD was associated with longer operative times (P < 0.01) and increased mortality (P < 0.01), but decreased estimated blood loss (P < 0.01), decreased delayed gastric emptying (P < 0.01), increased R0 resection rate (P < 0.01), decreased wound infection (P = 0.03) and shorter hospital stays (P < 0.01). There were no significant differences in BMI (P = 0.43), tumor size (P = 0.17), lymph nodes harvest (P = 0.57), POPF (P = 0.84), reoperation (P = 0.25) and 5-year survival rates (P = 0.82) for MIPD compared with OPD. Although there was an increased operative cost (P < 0.01) for MIPD compared with OPD, the postoperative cost was less (P < 0.01) with the similar total costs (P = 0.28). MIPD can be a reasonable alternative to OPD with the potential advantage of being minimally invasive. However, MIPD should be performed in high-volume centers and more randomized-controlled trials are needed to evaluate the appropriate indications of MIPD.

Association between red and processed meat intake and colorectal adenoma incidence and recurrence: a systematic review and meta-analysis

The associations between red and processed meat intake and colorectal adenoma (CRA) incidence and recurrence are inconclusive. We performed a systematic review and meta-analysis to analysis these associations. We conducted a systematic search of PubMed, EMBASE and Web of Science up to December 2016. The relative risks (RRs) and 95% confidence intervals (CIs) were assessed. Subgroup analyses, dose-response-analyses, subtype analyses and analyses of CRA locations were also conducted. Twenty-seven studies that involved 208,117 participants and 19,150 cases met criteria. The RRs of the highest versus lowest intakes for CRA incidence were 1.23 (1.15–1.31) for red meat and 1.15 (1.07–1.24) for processed meat. Dose-response analyses for meat per 100 g/day yielded the results were consistent with the original analyses, with 1.14 (1.07–1.20) for red meat and 1.27 (1.03–1.50) for processed meat. Additionally, there were no associations between red and processed meat intake and CRA recurrence, including total CRA (P > 0.05), advanced CRA (P > 0.05) and multiple CRA (P > 0.05). In conclusion, our findings support the hypothesis that red and processed meat intake was associated with an increased CRA incidence but not for CRA recurrence.

No associations between fruit and vegetable consumption and pancreatic cancer risk: a meta-analysis of prospective studies

The associations between fruit and vegetable consumption and pancreatic cancer risk are inconclusive. We conducted a meta-analysis of prospective studies to investigate the associations. The search was conducted systemically using the PubMed and EMBASE databases up to March 2017. Relative risks and 95% confidence intervals for the highest versus lowest consumption and dose-response analyses were assessed. Subtype and subgroup analyses were performed. Twelve studies were eligible. The summary relative risks of the highest versus lowest consumption were 0.95 (0.80–1.12) for total fruits and vegetables without heterogeneity (I2 = 0%, P = 0.44), 0.96 (0.82–1.12) for fruits without low heterogeneity (I2 = 37%, P = 0.12) and 0.94 (0.84–1.06) for vegetables with low heterogeneity (I2 = 9%, P = 0.36). Dose-response analyses also showed no significantly inverse associations for each 100 g/day increase; the summary relative risks were 1.00 (0.98–1.02) for total fruits and vegetables, 1.01 (0.97–1.05) for fruits and 1.00 (0.97–1.03) for vegetables. The results of subtype analyses were consistent with the fruit and vegetable analyses; the relative risks were 0.97 (0.80–1.17) for citrus fruit without low heterogeneity (I2 = 39%, P = 0.15) and 0.89 (0.76–1.05) for cruciferous vegetables without low heterogeneity (I2 = 14%, P = 0.32). In conclusion, this meta-analysis does not support significant associations between fruit and vegetable consumption and pancreatic cancer risk.