DataSheet_1_Association Between Cholecystectomy and Gastric Cancer Risk: A Systematic Review and Meta-Analysis.doc

ObjectivesAlthough several epidemiological studies have attempted to evaluate the relationship between cholecystectomy and gastric cancer risk, the findings have been controversial. This study aimed to carry out a systematic review and meta-analysis following the reporting guidelines to comprehensively analyze and quantify the evidence of the aforementioned association.MethodsStudies were identified by searching the Medline (PubMed), Embase, and Web of Science from inception to November 30, 2020, with only studies published in English being considered. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random-effects models.ResultsEight studies (five cohort studies and three case–control studies) with a total of 26,063 gastric cancer patients and 848,081 participants were included. The summarized RR of the relationship between cholecystectomy and gastric cancer risk was 1.11 (95%CI: 1.03–1.20), with low heterogeneity (P = 0.117, I2 = 37.8%). These positive findings were consistent in most subgroup analyses like region in Asia, number of cases ≥200, cohort study design, sex in male, low risk of bias, exposure collection by database, and adjustments made for age, gender, calendar year. Of note, we also observed positive association between cholecystectomy and non-cardia of gastric cancer risk (RR = 1.17, 95%CI: 1.04–1.33). No publication bias was present.ConclusionsThe aforementioned evidence suggested that a history of cholecystectomy was associated with a slightly elevated risk of gastric cancer. Results of most subgroup analyses also supported the main findings. More prospective studies are warranted to further validate these findings.

研究目标尽管多项流行病学研究尝试评估胆囊切除术与胃癌风险之间的关系，但研究结果存在争议。本研究旨在遵循报告指南，进行系统回顾和荟萃分析，全面分析和量化上述关联的证据。

研究方法通过检索Medline（PubMed）、Embase和Web of Science数据库，从数据库建立至2020年11月30日，仅纳入发表在英语国家的文献。采用随机效应模型计算汇总的相对风险（RR）和95%置信区间（CI）。

研究结果共纳入8项研究（5项队列研究和3项病例对照研究），涉及总共有26,063例胃癌患者和848,081名参与者。胆囊切除术与胃癌风险关系的汇总RR为1.11（95%CI：1.03–1.20），异质性较低（P = 0.117，I2 = 37.8%）。这些阳性发现与大多数亚组分析结果一致，如亚洲地区、病例数≥200、队列研究设计、男性性别、低偏倚风险、通过数据库收集暴露因素以及调整年龄、性别和日历年所做的调整。值得注意的是，我们还观察到胆囊切除术与非胃底胃癌风险之间的正相关（RR = 1.17，95%CI：1.04–1.33）。未发现发表偏倚。

结论上述证据表明，既往胆囊切除术史与胃癌风险略有升高相关。大多数亚组分析的结果也支持这一主要发现。需要更多前瞻性研究来进一步验证这些发现。