Beales Ian Leonard Phillip, Hensley Abigail, Loke Yoon
Ian Leonard Phillip Beales, Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, United Kingdom.
World J Gastrointest Pharmacol Ther. 2013 Aug 6;4(3):69-79. doi: 10.4292/wjgpt.v4.i3.69.
To examine the association between statin use and the development of esophageal cancer
We performed a systematic review and meta-analysis. Multiple databases (Pubmed, EMBASE, Cochrane Library, Web of Science, Wiley Interscience and Google Scholar) were systematically searched for studies reporting the association of statin use and the development of esophageal cancer. Literature searching and data abstraction were performed independently by two separate researchers. The quality of studies reviewed was evaluated using the Newcastle-Ottawa Quality assessment scale. Meta-analysis on the relationship between statin use and cancer incidence was performed. The effect of the combination of statin plus a cyclo-oxygenase inhibitor was also examined.
Eleven studies met eligibility criteria, 9 high and 2 medium quality. All were observational studies. Studies examining adenocarcinoma development in Barrett's esophagus included 317 cancers and 1999 controls, population-based studies examining all esophageal cancers included 371203 cancers and 6083150 controls. In the Barrett's population the use of statins (OR = 0.57; 95%CI: 0.43-0.75) and cyclo-oxygenase inhibitors (OR = 0.59; 95%CI: 0.45-0.77) were independently associated with a reduced incidence of adenocarcinoma. Combined use of a statin plus cyclo-oxygenase inhibitor was associated with an even lower adenocarcinoma incidence (OR = 0.26; 95%CI: 0.1-0.68). There was more heterogeneity in the population-based studies but pooled adjusted data showed that statin use was associated with a lower incidence of all combined esophageal cancers (OR = 0.81; 95%CI: 0.75-0.88).
Statin use in patients with Barrett's oesophagus is associated with a significantly lower incidence of adenocarcinoma. The chemopreventive actions of statins, especially combined with cyclo-oxygenase inhibitors deserve further exploration.
研究他汀类药物的使用与食管癌发生之间的关联
我们进行了一项系统评价和荟萃分析。系统检索了多个数据库（PubMed、EMBASE、Cochrane图书馆、科学网、Wiley Interscience和谷歌学术），以查找报告他汀类药物使用与食管癌发生关联的研究。文献检索和数据提取由两名独立的研究人员分别进行。使用纽卡斯尔-渥太华质量评估量表对所审查研究的质量进行评估。对他汀类药物使用与癌症发病率之间的关系进行荟萃分析。还研究了他汀类药物与环氧化酶抑制剂联合使用的效果。
11项研究符合纳入标准，9项高质量研究和2项中等质量研究。所有研究均为观察性研究。研究巴雷特食管腺癌发生情况的研究包括317例癌症患者和1999例对照，基于人群的研究所有食管癌患者包括371203例癌症患者和6083150例对照。在巴雷特食管人群中，使用他汀类药物（OR = 0.57；95%CI：0.43 - 0.75）和环氧化酶抑制剂（OR = 0.59；95%CI：0.45 - 0.77）与腺癌发病率降低独立相关。他汀类药物与环氧化酶抑制剂联合使用与更低的腺癌发病率相关（OR = 0.26；95%CI：0.1 - 0.68）。基于人群的研究中存在更多异质性，但汇总调整后的数据显示，使用他汀类药物与所有合并食管癌的较低发病率相关（OR = 0.81；95%CI：0.75 - 0.88）。
巴雷特食管患者使用他汀类药物与腺癌发病率显著降低相关。他汀类药物的化学预防作用，尤其是与环氧化酶抑制剂联合使用，值得进一步探索。
