Department of Anesthesiology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, 350001, China.
Eur J Clin Pharmacol. 2013 Oct;69(10):1855-60. doi: 10.1007/s00228-013-1547-z. Epub 2013 Jun 9.
Statins are widely prescribed to reduce cholesterol levels in the prevention of atherosclerotic cardiovascular disease. However, the debate about the effect of statins on cancer risk remains unsettled. The aim of this study was to investigate the association of utilization of statins with the risk of gastric cancer by carrying out a meta-analysis.
A literature search was performed on PubMed and EMBASE up to March 2013 to identify the cohort or case-control studies or randomized controlled trials (RCTs) that examined the relationship between statins use and the risk of gastric cancer. The bibliographies of the retrieved articles were also reviewed to identify additional studies. A random-effects model was used to calculate the summary relative risks (RRs) with 95 % confidence intervals (CIs).
Three post-hoc analyses of 26 RCTs involving 290 gastric cancers and eight observational studies totaling 7,321 gastric cancers were included. Statins use was shown to be significantly associated with a 27 % reduction in the risk of gastric cancer (RR = 0.73, 95 % CI = 0.58-0.93), with considerable heterogeneity among studies (I (2) = 88.9 %). Excluding one study in which all subjects are diabetic patients obtained an attenuated, but homogeneous result (RR = 0.85, 95 % CI = 0.80-0.91, I (2) = 0.0 %). These findings were consistent in the subgroup analysis.
A meta-analysis of existing evidence, primarily from observational studies, indicates that use of statins reduces the risk of gastric cancer.
他汀类药物被广泛用于降低胆固醇水平，以预防动脉粥样硬化性心血管疾病。然而，关于他汀类药物对癌症风险的影响的争论仍未解决。本研究旨在通过荟萃分析研究他汀类药物的使用与胃癌风险之间的关系。
对PubMed 和 EMBASE 进行了文献检索，检索截至 2013 年 3 月，以确定评估他汀类药物使用与胃癌风险之间关系的队列或病例对照研究或随机对照试验（RCT）。还对检索到的文章的参考文献进行了审查，以确定其他研究。使用随机效应模型计算汇总相对风险（RR）及其 95%置信区间（CI）。
纳入了 26 项 RCT 的 3 项事后分析，涉及 290 例胃癌病例和 8 项观察性研究，总计 7321 例胃癌病例。他汀类药物的使用与胃癌风险降低 27%显著相关（RR=0.73，95%CI=0.58-0.93），研究之间存在显著异质性（I 2=88.9%）。排除所有研究对象均为糖尿病患者的一项研究后，结果减弱但具有同质性（RR=0.85，95%CI=0.80-0.91，I 2=0.0%）。亚组分析结果一致。
对现有证据（主要来自观察性研究）的荟萃分析表明，他汀类药物的使用降低了胃癌的风险。
