인삼섭취와 위암발생의 위험: 관찰연구의 메타분석 = Ginseng Intake and Gastric Cancer Risk: A Meta-Analysis of Observational Epidemiological Studies

다국어 초록 (Multilingual Abstract)

Background: A number of observational studies have found that ginseng intake may reduce the risk of developing gastric cancer. However, studies have yielded inconsistent results as to whether consuming ginseng can lower the risk of gastric cancer. We conducted a meta-analysis of studies that assessed the association between ginseng intake and the risk of gastric cancer.
Methods: We searched MEDLINE, EMBASE, CINAHL, KMbase, KoreaMed, RiCH, National Assembly Library, Riss4u, and DBPIA for studies released through August 2007. We manually searched the references. Two authors independently extracted the data. To assess the quality of the studies Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist for case-control studies and cohort studies were used. Review Manager 5.0 (RevMan) was used for statistical analysis.
Results: We identified one case-control study and three cohort studies. The risk ratio (RR) for ginseng intake of all studies was 0.83 (95% confidence interval [CI], 0.46 to 1.51) and I2 = 91% for heterogeneity. We did subgroup analysis according to different types of study design, nation, and author. The results were consistent only when we did subgroup analysis according to authors. The RR of subgroup by different authors was 1.43 (95% CI, 1.10 to 1.80) and I2 = 0% without showing heterogeneity.
Conclusion: In this meta-analysis, the results suggested that there was insufficient evidence to confirm the association between ginseng intake and the risk of gastric cancer. Subsequent more powerful, well-designed, and larger observational epidemiological studies are needed to clarify the association.

국문 초록 (Abstract)

연구배경: 관찰 연구에서 인삼 섭취가 위암의 발생을 감소시킬 수도 있다고 제시되었으나 명확한 결론은 내려지지 않았다. 본 연구의 목적은 인삼 섭취와 위암 발생과의 관계를 평가한 관찰연구들을 메타 분석하여 체계적으로 고찰하고자 한다.
방법: 2008년 4월까지의 자료를 국외 PubMed, Embase,CiNAHL,국내 KMbase, KoreaMed, RiCH, 국회도서관, Riss4u,DBPIA를 이용해 검색하였고 전자 검색된 자료의 참고문헌을수기 검색하였다. 두 명의 리뷰 저자가 자료 추출 양식을 사용하여 연구 설계, 대상자 수와 특성, 인삼의 섭취량과 종류, 추적관찰기간, 결과변수와 효과의 크기, 보정한 혼란변수의 보정자료를 추출하였다. 연구의 질을 평가하기 위해서는 관찰연구 질 평가도구인 Scottish Intercollegiate Guidelines Network의체크리스트를 이용하였다. 결과 관계를 보기 위한 프로그램으로는 Review Manager 5.0 (RevMan)을 사용하였으며 연구간출판 비뚤림 존재 여부를 평가하기 위해 funnel plot을 작성하여 조사하였다.
결과: 총 환자-대조군 연구 1편과 코호트 연구 3편이 선택되었다. 전체 인삼 섭취에 대한 risk ratio (RR)은 0.83 (95% condence interval [CI], 0.46-1.51), 이질성에 대한 I2=92%이었다. 이에 대해 이질성 원인을 조사하기 위해 1. 연구 설계, 2. 논문을 발표한 나라, 3. 저자들을 기준으로 부집단을 나누어 분석하였다.
부집단을 분석한 결과 동일한 저자가 포함되었던 연구외의 2연구에 대한 RR이 1.43 (95% CI, 1.10-1.84), I2=0%로 이질성이해소되었다.
결론: 본 메타분석 결과 인삼섭취와 위암 발생 위험도의 관계를 부정적 또는 긍정적 어느 한쪽으로 판단하기에는 근거가불충분하였다. 따라서 향후 이 관계를 명확히 규명할 수 있는대규모 관찰연구들이 필요하다.

참고문헌 (Reference)

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