Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland.
Cancer Epidemiol. 2012 Oct;36(5):421-4. doi: 10.1016/j.canep.2012.05.006. Epub 2012 Jun 7.
Statins (HMG-CoA-reductase inhibitors) are suggested to act as a predisposing factor for autoimmune diseases, have immunomodulatory effects, and possibly prevent some cancer types - the sum of these effects is unknown in cancers of viral aetiology, such as Merkel cell carcinoma (MCC). Aim of our study was to find out whether statin users in Finland have an increased incidence of MCC.
A cohort of 224715 male and 230220 female statin users during 1994-2007 was identified from the Prescription Register of the National Social Insurance Institution. This cohort was followed up through the Finnish Cancer Registry for MCC up to 2009.
There were altogether 50 cases of MCCs, while the expected number of cases, calculated on the basis of the MCC incidence in comparable Finnish population, was 39.9 (SIR 1.25, 95% CI 0.93-1.65). The standardized incidence ratio (SIR) for MCC in ages <60 years was 3.16 (95% CI 0.65-9.23), in ages 60-74 years 1.94 (95% CI 1.23-2.90) and in ages ≥75 years 0.89 (95% CI 0.57-1.31). The relative risk of MCC decreased significantly, 0.79 fold (95% CI 0.67-0.92), at each 5 year step when moving towards older age groups. There was no significant variation in SIR related to years since starting the statin use, or between the genders.
MCC is the first neuroendocrine cancer linked to statin use. The association is statistically significant and biologically plausible through immunomodulatory effects of statins. The excess of MCCs was observed in atypically young patients, a similar phenomenon as noted earlier in patients with immunocompromising states.
他汀类药物（HMG-CoA 还原酶抑制剂）被认为是自身免疫性疾病的诱发因素，具有免疫调节作用，并且可能预防某些癌症类型——这些作用的总和在病毒性病因的癌症中尚不清楚，例如 Merkel 细胞癌（MCC）。我们研究的目的是确定芬兰的他汀类药物使用者是否患有 MCC 的发病率增加。
从国家社会保险机构的处方登记册中确定了 1994-2007 年间的 224715 名男性和 230220 名女性他汀类药物使用者队列。通过芬兰癌症登记处对该队列进行了 MCC 的随访，直至 2009 年。
共有 50 例 MCC 病例，而根据可比芬兰人群的 MCC 发病率计算出的预期病例数为 39.9（SIR 1.25，95%CI 0.93-1.65）。年龄<60 岁的 MCC 的标准化发病比（SIR）为 3.16（95%CI 0.65-9.23），年龄 60-74 岁为 1.94（95%CI 1.23-2.90），年龄≥75 岁为 0.89（95%CI 0.57-1.31）。当向年龄较大的年龄组移动时，MCC 的相对风险显著降低，每 5 年降低 0.79 倍（95%CI 0.67-0.92）。与开始使用他汀类药物的年限或性别无关，SIR 无明显变化。
MCC 是与他汀类药物使用相关的第一种神经内分泌癌。这种关联具有统计学意义，并且通过他汀类药物的免疫调节作用在生物学上是合理的。在异常年轻的患者中观察到 MCC 过多，这与先前在免疫功能低下状态的患者中观察到的现象相似。
