Department of Medical Oncology.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, USA.
Ann Oncol. 2013 Jul;24(7):1721-1730. doi: 10.1093/annonc/mdt150. Epub 2013 Apr 18.
Several observational studies have shown that statins may modify the risk of gastric cancer (GC). We carried out a systematic review and meta-analysis of studies evaluating the effect of statins on GC risk.
We conducted a systematic search of multiple databases up to December 2012. Studies that evaluated exposure to statins, reported GC outcomes and odds ratio (OR) or provided data for their estimation were included in the meta-analysis. Pooled OR estimates with 95% confidence intervals (CIs) were calculated using the random-effects model.
Eleven studies (eight observational, three post-hoc analyses of 26 clinical trials) reporting 5581 cases of GC were included. Meta-analysis showed a significant 32% reduction in GC risk with statin use (adjusted OR, 0.68; 95% CI, 0.51-0.91). After exclusion of one study which was contributing to considerable heterogeneity, a significant 16% reduction in GC risk was a more conservative, consistent estimate (adjusted OR, 0.84; 95% CI, 0.78-0.90). This chemopreventive association was present in both Asian (adjusted OR, 0.68; 95% CI, 0.53-0.87) and Western population (adjusted OR, 0.86; 95% CI, 0.79-0.93).
Meta-analysis of studies supports a protective association between statin use and GC risk, in both Asian and Western population, in a dose-dependent manner.
几项观察性研究表明，他汀类药物可能会改变胃癌（GC）的风险。我们进行了一项系统评价和荟萃分析，评估了他汀类药物对 GC 风险的影响。
我们对多个数据库进行了系统搜索，截至 2012 年 12 月。评估他汀类药物暴露、报告 GC 结局和比值比（OR）或提供数据以进行估计的研究被纳入荟萃分析。使用随机效应模型计算合并 OR 估计值及其 95%置信区间（CI）。
纳入了 11 项研究（8 项观察性研究，3 项 26 项临床试验的事后分析），报告了 5581 例 GC 病例。荟萃分析显示，他汀类药物使用可使 GC 风险降低 32%（调整 OR，0.68；95%CI，0.51-0.91）。排除一项对异质性有较大贡献的研究后，GC 风险降低 16%的结果更为保守和一致（调整 OR，0.84；95%CI，0.78-0.90）。这种化学预防相关性在亚洲人群（调整 OR，0.68；95%CI，0.53-0.87）和西方人群（调整 OR，0.86；95%CI，0.79-0.93）中均存在。
对研究的荟萃分析支持他汀类药物使用与 GC 风险之间存在保护相关性，在亚洲和西方人群中均呈剂量依赖性。
