Meta-analysis Of The Relationship Between Helicobacter Pylori Infection And Pancreatic Cancer

Objective This study was systematically evaluate the relationship between Helicobacter Pylori and Pancreatic Cancer.Methods The literatures about Helicobacter Pylori and Pancreatic Cancer published in the database from Pub Med,Embase,Cochrane Library,Web of Science,CNKI,Wanfang Database,and Weipu Database from the beginning to January 2019.The literatures that met the inclusion criteria were collected and assessed by Newcastle-Ottawa Scale,and then Rev Man 5.3 statistical software was used to calculate the combined pooled odd ratio(OR value)and its 95% confidence interval(95% CI).Heterogeneity among the studies was processed by sensitivity analysis and subgroup analysis.Result A total of 6613 study subjects were included in 14 articles at last,including 2877 patient cases and 3736 controls.Fourteen studies combined OR=1.53(95% CI:1.20~1.96,P =0.0007).According to different subgroups analyses in the study area.The Asian(OR=2.22,95% CI: 1.55~3.19,P<0.0001)indicates that H.pylori infection is associated with pancreatic cancer,while Europe(OR=1.22,95% CI: 0.93~1.61,P =0.16)and the North American(0R =0.95,95% CI: 0.49~1.82,P=0.87)indicated that H.pylori infection was not associated with pancreatic cancer.In addition,10 studies examined Cag A,combined with OR=1.32(95% CI: 1.04~1.67,P =0.02),subgroup analysis in different study areas,Asian population(OR = 1.69,95% CI: 1.12~3.41,P<0.00001),suggesting that Cag A positivity is associated with pancreatic cancer,European(OR = 1.11,95% CI: 0.82~1.51,P = 0.51)and North American(0R = 0.95,95% CI: 0.49 ~1.82,P=0.87),both suggest that no significant relationship between Cag A positivity and pancreatic cancer.Sensitivity analysis and publication bias analysis indicate that the results are relatively stable and reliable.Conclusion H.pylori infection and Cag A positivity strain are associated with pancreatic cancer in Asian populations,but not in European and North American populations.