Yi Xiao, Jia Wei, Jin Yin, Zhen Shang
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
PLoS One. 2014 Jan 31;9(1):e87019. doi: 10.1371/journal.pone.0087019. eCollection 2014.
Several observational studies have shown that statin use may modify the risk of haematological malignancies. To quantify the association between statin use and risk for haematological malignancies, we performed a detailed meta-analysis of published studies regarding this subject.
We conducted a systematic search of multiple databases including PubMed, Embase, and Cochrane Library Central database up to July 2013. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses and sensitivity analysis were also performed.
A total of 20 eligible studies (ten case-control studies, four cohort studies, and six RCTs) reporting 1,139,584 subjects and 15,297 haematological malignancies cases were included. Meta-analysis showed that statin use was associated with a statistically significant 19% reduction in haematological malignancies incidence (RR = 0.81, 95% CI [0.70, 0.92]). During subgroup analyses, statin use was associated with a significantly reduced risk of haematological malignancies among observational studies (RR = 0.79, 95% CI [0.67, 0.93]), but not among RCTs (RR = 0.92, 95% CI [0.77, 1.09]).
Based on this comprehensive meta-analysis, statin use may have chemopreventive effects against haematological malignancies. More studies, especially definitive, randomized chemoprevention trials are needed to confirm this association.
多项观察性研究表明,使用他汀类药物可能会改变血液系统恶性肿瘤的风险。为了量化他汀类药物使用与血液系统恶性肿瘤风险之间的关联,我们对已发表的关于该主题的研究进行了详细的荟萃分析。
我们对包括PubMed、Embase和Cochrane图书馆中央数据库在内的多个数据库进行了系统检索,检索截至2013年7月。采用固定效应模型和随机效应模型来估计汇总相对风险(RR)及相应的95%置信区间(CI)。通过Meta回归检测异质性的潜在来源。还进行了亚组分析和敏感性分析。
共纳入20项符合条件的研究(10项病例对照研究、4项队列研究和6项随机对照试验),涉及1,139,584名受试者和15,297例血液系统恶性肿瘤病例。荟萃分析表明,使用他汀类药物与血液系统恶性肿瘤发病率在统计学上显著降低19%相关(RR = 0.81,95%CI [0.70, 0.92])。在亚组分析中,在观察性研究中使用他汀类药物与血液系统恶性肿瘤风险显著降低相关(RR = 0.79,95%CI [0.67, 0.93]),但在随机对照试验中并非如此(RR = 0.92,95%CI [0.77, 1.09])。
基于这项全面的荟萃分析,使用他汀类药物可能对血液系统恶性肿瘤具有化学预防作用。需要更多的研究,尤其是确定性的随机化学预防试验来证实这种关联。