Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Cancer Causes Control. 2012 Jul;23(7):1099-111. doi: 10.1007/s10552-012-9979-9. Epub 2012 May 5.
Statins are commonly prescribed medications that potently reduce cholesterol levels and the risk of cardiovascular events. Preclinical studies suggested statins also possess cancer chemopreventive properties. However, the clinical studies provided contradictory results as to whether statins influence the risk of pancreatic cancer. Herein, we present this meta-analysis to assess the association between statin use and risk of pancreatic cancer.
We conducted a comprehensive search up to August 2011 for the eligible studies. Pooled relative risk (RR) estimates and corresponding 95 % confidence intervals (CIs) were calculated using the inverse-variance-weighted random-effects model. Subgroup analyses were conducted where data were available. Heterogeneity was assessed by the Cochran's Q test and the I(2) statistic.
We included 16 studies that involving 1,692,863 participants and 7,807 pancreatic cancer cases. Pooled results only indicated a non-significant decrease of pancreatic cancer risk among all statin users (RR 0.89; 95 % CIs, 0.74-1.07). Similar results were obtained in the subgroup analyses of the long-term (more than 4 years) follow-up (RR 0.94, 0.81-1.08) and statin use (RR 0.97, 0.76-1.23), and a null association was found between lipophilic statin use and pancreatic cancer risk (RR 1.03, 0.92-1.16). No evidence of publication bias was observed in the present meta-analysis. However, significant heterogeneity was detected among all studies (p < 0.00001, I(2) = 81 %).
In conclusion, our results suggest that there is no association between statin use and pancreatic cancer risk, when statins are taken at daily doses for cardiovascular event prevention.
他汀类药物是一种常用的降胆固醇药物,能显著降低心血管事件的风险。临床前研究表明,他汀类药物还具有抗癌化学预防作用。然而,关于他汀类药物是否影响胰腺癌风险的临床研究结果却相互矛盾。在此,我们进行了这项荟萃分析,以评估他汀类药物的使用与胰腺癌风险之间的关联。
我们对截至 2011 年 8 月的合格研究进行了全面检索。使用基于逆方差加权的随机效应模型计算了合并的相对风险(RR)估计值和相应的 95%置信区间(CI)。当数据可用时,进行了亚组分析。通过 Cochran's Q 检验和 I(2)统计量评估了异质性。
我们纳入了 16 项研究,共涉及 1692863 名参与者和 7807 例胰腺癌病例。汇总结果仅表明,所有他汀类药物使用者的胰腺癌风险无显著降低(RR 0.89;95%CI,0.74-1.07)。在长期(超过 4 年)随访的亚组分析(RR 0.94,0.81-1.08)和他汀类药物使用的亚组分析(RR 0.97,0.76-1.23)中也得到了类似的结果,并且亲脂性他汀类药物使用与胰腺癌风险之间也没有关联(RR 1.03,0.92-1.16)。本荟萃分析未发现发表偏倚的证据。然而,所有研究之间存在显著的异质性(p < 0.00001,I(2) = 81%)。
总之,当他汀类药物以每日剂量用于预防心血管事件时,我们的结果表明他汀类药物的使用与胰腺癌风险之间没有关联。