CPAP是否增加或保护OSA的癌症风险:系统性审查和元分析
Narat Srivali1,2, Federica De Giacomi3
1Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC, USA. narat.srivali@duke.edu.
Sleep & breathing = Schlaf & Atmung
|May 1, 2025
概括
对阻塞性睡眠呼吸暂停 (OSA) 的持续正气道压力 (CPAP) 治疗可能不会增加癌症风险. 这次系统性审查发现有限的证据表明潜在的减少,但需要更多的研究才能得出确的结果.
科学领域:
- 睡眠医学 睡眠医学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与间歇性缺氧和炎症等因素有关,这些因素可能会影响癌症的发展.
- 持续正气道压力 (CPAP) 是标准的OSA治疗方法,但其对癌症发病率的影响尚不清楚.
研究的目的:
- 系统地审查和元分析CPAP治疗与OSA患者新癌症诊断之间的关联.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Cochrane) 进行了全面的文献搜索,截至2025年3月.
- 包括观察性研究,比较OSA患者的癌症风险,有或没有CPAP治疗,遵守PRISMA指南.
- 分析利用一个随机效应模型,从三项涉及72,498名参与者的队列研究中汇集数据.
主要成果:
- 在CPAP使用者中,癌症发病率的综合危险比率 (HR) 为0.81 (95% CI:0.60-1.09),表明潜在的风险降低.
- 敏感性分析,减少异质性,产生了0.93的HR (95%CI:0.81-1.08).
- 癌症诊断通过国家登记册或电子医疗记录得到确认.
结论:
- 目前的证据表明,CPAP治疗不会提高OSA患者的癌症风险.
- 然而,现有的数据是有限的和不确定的.
- 进一步的研究,包括随机对照试验,对于验证这些发现和阐明潜在机制至关重要.
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