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他汀类药物使用与结直肠癌风险之间的关联:42项研究的荟萃分析。

Association between statin use and colorectal cancer risk: a meta-analysis of 42 studies.

作者信息

Liu Yanqiong, Tang Weizhong, Wang Jian, Xie Li, Li Taijie, He Yu, Deng Yan, Peng Qiliu, Li Shan, Qin Xue

机构信息

Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.

出版信息

Cancer Causes Control. 2014 Feb;25(2):237-49. doi: 10.1007/s10552-013-0326-6. Epub 2013 Nov 22.

Abstract

PURPOSE

There is a long-standing debate about whether statins have chemopreventive properties against colorectal cancer (CRC), but the results remain inconclusive. We therefore present a meta-analysis to investigate the association between statin use and risk of CRC.

METHODS

A comprehensive literature search was undertaken through July 2013 looking for eligible studies. Pooled relative risk (RR) estimates and 95 % confidence intervals (CIs) were used to calculate estimated effect.

RESULTS

Forty-two studies [18 case-control studies, 13 cohort studies, and 11 randomized controlled trials (RCTs)] were included in this analysis. Overall, statin use was associated with a modest reduction in the risk of CRC (RR = 0.90, 95 % CI 0.86-0.95). When the analyses were stratified into subgroups, a significant decreased association of CRC risk was observed in observational studies (RR = 0.89, 95 % CI 0.84-0.95), rectal cancer (RR = 0.81, 95 % CI 0.66-0.99), and lipophilic statin (RR = 0.88, 95 % CI 0.85-0.93), but not in RCTs (RR = 0.96, 95 % CI 0.85-1.08), colon cancer, and hydrophilic statin. However, long-term statin use (≥5 years) did not significantly affect the risk of CRC (RR = 0.96, 95 % CI 0.90-1.03). Cumulative meta-analysis showed that statin use significantly reduces the risk of CRC, which has been available between 2007 and 2013.

CONCLUSIONS

Our results suggest that statin use is associated with a modest reduced risk of CRC; apparent associations were found for lipophilic statin use. However, long-term statin use did not appear to significantly affect the risk of CRC.

摘要

目的

关于他汀类药物是否具有预防结直肠癌(CRC)的化学预防特性存在长期争论,但结果仍无定论。因此,我们进行了一项荟萃分析,以研究他汀类药物的使用与CRC风险之间的关联。

方法

截至2013年7月进行了全面的文献检索,以寻找符合条件的研究。汇总相对风险(RR)估计值和95%置信区间(CIs)用于计算估计效应。

结果

本分析纳入了42项研究[18项病例对照研究、13项队列研究和11项随机对照试验(RCTs)]。总体而言,使用他汀类药物与CRC风险适度降低相关(RR = 0.90,95% CI 0.86 - 0.95)。当分析分层为亚组时,在观察性研究(RR = 0.89,95% CI 0.84 - 0.95)、直肠癌(RR = 0.81,95% CI 0.66 - 0.99)和亲脂性他汀类药物(RR = 0.88,95% CI 0.85 - 0.93)中观察到CRC风险有显著降低的关联,但在RCTs(RR = 0.96,95% CI 0.85 - 1.08)、结肠癌和亲水性他汀类药物中未观察到。然而,长期使用他汀类药物(≥5年)并未显著影响CRC风险(RR = 0.96,95% CI 0.90 - 1.03)。累积荟萃分析表明,2007年至2013年期间使用他汀类药物可显著降低CRC风险。

结论

我们的结果表明,使用他汀类药物与CRC风险适度降低相关;亲脂性他汀类药物的使用存在明显关联。然而,长期使用他汀类药物似乎并未显著影响CRC风险。

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