Li Wen, Shi Qi, Wang Weibing, Liu Jianrong, Li Qi, Hou Fenggang
Oncology Department of Shanghai Municipal Hospital of Traditional Chinese Medicine affiliated to Shanghai TCM University, Shanghai, China.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
PLoS One. 2014 Sep 3;9(9):e105801. doi: 10.1371/journal.pone.0105801. eCollection 2014.
Studies on the association between the use of calcium channel blockers (CCBs) and breast cancer risk have reported inconsistent results. We quantitatively assessed this association by conducting a meta-analysis based on the evidence from observational studies.
We searched PubMed, MEDLINE, EMBASE and the Cochrane Library for relevant studies published up to and including December 31, 2013. We calculated pooled risk ratios (RRs) for cancer risk.
A total of 17 studies (9 cohort studies, 8 case-control studies) were selected for further study. These studies included 149,607 female subjects, of which 53,812 were CCBs users, who were followed for 2-16 years. The risks of breast cancer among patients receiving CCBs were significantly different for the pooled RRs (95% confidence interval) of cohort studies 1.08 (0.95, 1.20) and case-control studies 0.98 (0.86, 1.09). Differences were also noted for cancer risk, for CCBs use of <5 years 0.96 (0.78, 1.15), and for >5 years 1.01 (0.74, 1.28), as well as for ever used 1.08 (0.95, 1.20), and for current use 1.13 (0.83, 1.42). The RR for studies longer than 10 years was 1.71 (1.01, 2.42), and for studies evaluating nifedipine was 1.10 (0.87, 1.33) and diltiazem was 0.75 (0.40, 1.10).
The long-term use of CCBs appears to have a significant relationship with breast cancer. Well-designed clinical trials are needed to optimize the doses and types of these drugs needed to minimize their carcinogenic potential.
关于使用钙通道阻滞剂(CCB)与乳腺癌风险之间关联的研究报告结果不一致。我们基于观察性研究的证据进行荟萃分析,对这种关联进行了定量评估。
我们检索了PubMed、MEDLINE、EMBASE和Cochrane图书馆,查找截至2013年12月31日(含该日)发表的相关研究。我们计算了癌症风险的合并风险比(RR)。
共选择了17项研究(9项队列研究,8项病例对照研究)进行进一步研究。这些研究包括149,607名女性受试者,其中53,812名是CCB使用者,随访时间为2至16年。队列研究的合并RR(95%置信区间)为1.08(0.95,1.20),病例对照研究为0.98(0.86,1.09),接受CCB治疗的患者中乳腺癌风险存在显著差异。在癌症风险方面也发现了差异,CCB使用时间<5年为0.96(0.78,1.15),>5年为1.01(0.74,1.28),曾经使用为1.08(0.95,1.20),当前使用为1.13(0.83,1.42)。超过10年的研究RR为1.71(1.01,2.42),评估硝苯地平的研究为1.10(0.87,1.33),地尔硫䓬为0.75(0.40,1.10)。
长期使用CCB似乎与乳腺癌有显著关系。需要设计良好的临床试验来优化这些药物的剂量和类型,以尽量降低其致癌潜力。