| Objective:Proton pump inhibitor（PPI）has been widely used in reflux esophagitis,chronic gastritis,digestive ulcer and other digestive system diseases since 1980 s.Fundic gland polyps（FGPs）refers to the protuberant lesions,which are originating in the gastric mucosa or submucosa and protruding into the gastric cavity,usually occurring in the glandular mucosa of the gastric fundic gland without atrophy.With the development and wide application of endoscopic technology,gastric polyps can be found in about 1%to 6% of gastric endoscopy.The fundic gland polyp was the most common type of gastric polyp,accounting for about 77% of all gastric polyps.Studies have shown that long-term use of PPI is associated with the occurrence and development of fundic gland polyps and gastric cancer.However,the relationship between long-term use of PPI and the occurrence of fundic gland polyps is still controversial and the pathogenesis is still unclear,which has aroused the attention of scholars.At present,there are original literatures about the correlation between long-term application of PPI and occurrence of fundic gland polyps at home and abroad.This paper conducted a meta-analysis of existing research data to draw more objective and accurate conclusions.Method:Pub Med,Embase,Cochrane,CNKI,Wanfang,and VIP were used to search for articles on the correlation between long-term use of PPI and fundic gland polyps from1992 to 2021 in any language.The quality of the included cohort and case-control studies was assessed using the Newcastle-Ottawa Quality Assessment Scale（NOS）.The included data were analyzed by Revman5.4.1 and Stata16.The odds ratio（OR）and its 95% confidence interval（95% CI）were calculated by random effects model（REM）.Subgroup analysis and sensitivity analysis were performed,and publication bias was evaluated by funnel plot,Egger test and Begg test.Result:1.A total of 14 studies were included,consisting of 9 cohort studies and 5 casecontrol studies,with 41,835 subjects,which were published between 1998 and 2020.The studies included are from China（5 pieces）,the United States（4 pieces）,the Netherlands（1 piece）,Brazil（1 piece）,Japan（1 piece）,Portugal（1 piece）and Argentina（1 piece）.2.After a review of 14 studies,meta-analysis results show that the incidence of FGPs was higher in PPI users than in non-PPI users（OR=2.74,95%CI: 1.69-4.42,P <0.01,I2=93%）.3.There was heterogeneity in this meta-analysis.Subgroup analysis was conducted according to different research types,countries and regions,and PPI duration.The results showed that in the subgroup analysis of the type studied in this paper,both cohort and case-control studies showed that long-term use of PPI was associated with the occurrence of fundic gland polyps.The values are（OR=3.00,95%CI:1.53-5.90,P=0.001,I2=94%）and（OR=2.35,95%CI: 1.04-5.30,P=0.04,I2=93%）.Long-term use of PPI can increase the prevalence of fundic gland polyps in China and abroad.The values were（OR=2.07,95%CI: 1.00-4.28,P=0.05,I2=93%）and（OR=3.26,95%CI:1.59-6.71,P=0.001,I2=94%）.There was no significant correlation between using PPI for less than 1 year and the occurrence of fundic gland polyps（OR=1.71,95%CI: 0.96-3.03,P=0.07,I2=93%）,while using PPI for 1 year or more was associated with the occurrence of fundic gland polyps（OR=3.45,95%CI:1.62-7.34,P=0.001,I2=90%）.4.The sensitivity analysis shows that the results are stable and reliable.The funnel plot,Egger test and Begg test results showed that there was no publication bias in the study（P>0.05）.Conclusion:Long-term use of PPI may lead to the occurrence of fundic gland polyps,and with the prolonged use of PPI,the possibility of fundic gland polyps will increase.At present,multi-center and large sample studies are still needed to further confirm the relationship between the two. |
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