实用妇产科杂志2013年3月第29卷第3期 Journal of Practical Obstetrics and gynecology2013Mar.Vo.29,N.3 文章编号:1003-6946(2013)03-184-06 维生素C与宫颈癌关系的Meta分析 何丽娜,陈炜,王丽娜,黄莺莺,吴兰芳,刘萍,陈春林,钟梅,王薇 (南方医科大学南方医院,广东广州510515) 摘要】目的:探讨维生素C摄入水平与宫颈癌发病之间的关系。方法:检索1980年1月至 2012年2月公开发表的有关维生素C摄入水平与宫颈癌关系的研究文献,使用 Review manager 4.2对符合纳入标准的文献按照不同指标进行定量合成分析。结果:①总纳入10篇文献共8066 个病例,按各研究文献标准将摄入维生素C的含量分为4个等级(Q1、Q2、Q3、Q4),高于最低含 量Q1者视为维生素C摄入量较高。②以每日总摄入量为指标时,维生素C摄入量>Q1组和Ql 组两组间比较,病例组和对照组差异有统计学意义(P<0.05);对每日总摄入量Q2、Q3、Q4进行 亚组分析,Q2亚组尚不能认为病例与对照组间差异有统计学意义(P>0.05),Q3、Q4亚组组间 差异有统计学意义(P<0.05)。③以每日膳食摄入量为指标时,维生素C摄入量>Q1组和Q1组 两组间比较,病例组和对照组差异有统计学意义(P<0.05);对每日膳食摄入量Q2、Q3、q4进行 亚组分析,病例与对照组差异均有统计学意义(P<0.05)。结论:较高的维生素C摄入水平是宫 颈癌发病的保护因素,且随着维生素C摄入水平的增高,宫颈癌发病风险逐渐降低 【关键词】维生素C;宫颈癌;Meta分析 中图分类号:R737.33 文献标识码:A Meta-Analysis of the Relationship between Vitamin C and Cervical Cancer HE Lina, CHEN Wei, WANG Lina, et Department of Gynecology and Obstetrics, Guangzhou, Nan Fang Hospital, Sourthern Medical University Guangzhou Guangdong 510515, China) Corresponding author: WANG Wei (Abstract] Objective: To explore the relationship between Vitamin C and cervical cancer. Methods: The litera- tures about the association between vitamin C and cervical cancer from January 1980 to February 2012 were searched for inclusion and exclusion criteria, and the data in the studies selected were analyzed by RevMan 4. 2 software. Results: (110 studies and a total of 8066 caseswere enrolled in this analysis according to the cri- teria. The Vitamin C intake was divided into four grade according to every study (Q1, Q2. 03, Q4). 2 For the daily total Vitamin C intake, there were significant differences between cases and controls in the group Q and group daily total Vitamin C intake >Q1(P<0. 05). For sub-group analysis of daily total Vitamin C intake Q2, Q3, Q4, the sub-group of C2 was not different between cases and controls( P>0. 05), but there were sig nificant differences between cases and controls in Q3, Q4(P<0. 05). 3 For the daily dietary Vitamin C in- take, there are significant differences between cases and controls in the group Q1 and group daily dietary Vi- tamin C intake >Q1(P<0. 05): For sub-group analysis of daily dietary Vitamin C intake Q2 Q3, Q4, there are significant differences between cases and controls in all three subgroups(P<0. 05). Conclusions: High intake of vitamin C was a protective factor of cervical cancer. Along with the increasing intake of vitamin C, the risk of cervical cancer was reduced (Key words) Vitamin C: Cervical cancer; Meta-analysis 宫颈癌是世界上危害妇女健康最常见的恶性肿境因素、营养膳食因素等,也被认为是宫颈癌发生、发 瘤之一,其发病率位居全球妇科恶性肿瘤第2位。展的促发因素。营养膳食因素是日常生活中暴露频 目前已明确HPⅤ持续性感染是宫颈癌的最主要病率最高的疾病促发因素,其中维生素C是营养膳食因 因B,除此之外,其他诸多致病因素如遗传因素、环素中比较重要的成分,各国学者在关于营养膳食因素 基金项目:国家自然科学基金(编号:81072132:30973193) 通讯作者:王薇,Email:silent66@yaho.com.cn C1994-2013ChinaAcademicJOurnalElectronicPublishingHouse.Allrightsreservedhttp://www.cnki.net实用妇产科杂志 2013 年 3 月第 29 卷第 3 期 Journal of Practical Obstetrics and Gynecology 2013 Mar． Vol． 29，No． 3 基金项目: 国家自然科学基金( 编号: 81072132; 30973193) 通讯作者: 王 薇，Email: smilenn66@ yahoo． com． cn 文章编号: 1003－6946( 2013) 03－184－06 维生素 C 与宫颈癌关系的 Meta 分析 何丽娜，陈 炜，王丽娜，黄莺莺，吴兰芳，刘 萍，陈春林，钟 梅，王 薇 ( 南方医科大学南方医院，广东 广州 510515) 【摘要】 目的: 探讨维生素 C 摄入水平与宫颈癌发病之间的关系。方法: 检索 1980 年 1 月至 2012 年 2 月公开发表的有关维生素 C 摄入水平与宫颈癌关系的研究文献，使用 Review Manager 4. 2 对符合纳入标准的文献按照不同指标进行定量合成分析。结果: ①总纳入 10 篇文献共 8066 个病例，按各研究文献标准将摄入维生素 C 的含量分为 4 个等级( Q1、Q2、Q3、Q4) ，高于最低含 量 Q1 者视为维生素 C 摄入量较高。②以每日总摄入量为指标时，维生素 C 摄入量＞Q1 组和 Q1 组两组间比较，病例组和对照组差异有统计学意义( P＜0. 05) ; 对每日总摄入量 Q2、Q3、Q4 进行 亚组分析，Q2 亚组尚不能认为病例与对照组间差异有统计学意义( P ＞0. 05) ，Q3、Q4 亚组组间 差异有统计学意义( P＜0. 05) 。③以每日膳食摄入量为指标时，维生素 C 摄入量＞Q1 组和 Q1 组 两组间比较，病例组和对照组差异有统计学意义( P＜0. 05) ; 对每日膳食摄入量 Q2、Q3、Q4 进行 亚组分析，病例与对照组差异均有统计学意义( P＜0. 05) 。结论: 较高的维生素 C 摄入水平是宫 颈癌发病的保护因素，且随着维生素 C 摄入水平的增高，宫颈癌发病风险逐渐降低。 【关键词】 维生素 C; 宫颈癌; Meta 分析 中图分类号: R737. 33 文献标识码: A Meta-Analysis of the Relationship between Vitamin C and Cervical Cancer HE Lina，CHEN Wei，WANG Lina，et al ( Department of Gynecology and Obstetrics，Guangzhou，Nan Fang Hospital，Sourthern Medical University， Guangzhou Guangdong 510515，China) Corresponding author: WANG Wei 【Abstract】 Objective: To explore the relationship between Vitamin C and cervical cancer． Methods: The litera￾tures about the association between Vitamin C and cervical cancer from January 1980 to February 2012 were searched for inclusion and exclusion criteria，and the data in the studies selected were analyzed by RevMan 4. 2 software． Results: ①10 studies and a total of 8066 caseswere enrolled in this analysis according to the cri￾teria． The Vitamin C intake was divided into four grade according to every study( Q1、Q2、Q3、Q4) ． ②For the daily total Vitamin C intake，there were significant differences between cases and controls in the group Q1 and group daily total Vitamin C intake ＞Q1( P＜0. 05) ． For sub-group analysis of daily total Vitamin C intake Q2、Q3、Q4，the sub-group of Q2 was not different between cases and controls( P＞0. 05) ，but there were sig￾nificant differences between cases and controls in Q3、Q4( P＜0. 05) ． ③For the daily dietary Vitamin C in￾take，there are significant differences between cases and controls in the group Q1 and group daily dietary Vi￾tamin C intake ＞Q1( P＜0. 05) ; For sub-group analysis of daily dietary Vitamin C intake Q2、Q3、Q4，there are significant differences between cases and controls in all three subgroups( P＜0. 05) ． Conclusions: High intake of Vitamin C was a protective factor of cervical cancer． Along with the increasing intake of Vitamin C，the risk of cervical cancer was reduced． 【Key words】 Vitamin C; Cervical cancer; Meta-analysis 宫颈癌是世界上危害妇女健康最常见的恶性肿 瘤之一，其发病率位居全球妇科恶性肿瘤第 2 位［1］。 目前已明确 HPV 持续性感染是宫颈癌的最主要病 因［2，3］，除此之外，其他诸多致病因素如遗传因素、环 境因素、营养膳食因素等，也被认为是宫颈癌发生、发 展的促发因素。营养膳食因素是日常生活中暴露频 率最高的疾病促发因素，其中维生素 C 是营养膳食因 素中比较重要的成分，各国学者在关于营养膳食因素 ·184·