Pradelli Danitza, Soranna Davide, Zambon Antonella, Catapano Alberico, Mancia Giuseppe, La Vecchia Carlo, Corrao Giovanni
Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy.
Department of Pharmacological Sciences, University of Milano, Milan, Italy.
Cancer Med. 2015 May;4(5):770-80. doi: 10.1002/cam4.411. Epub 2015 Mar 21.
In order to quantify the association between use of statins and the risk of all hematological malignancies and of subtypes, we performed a meta-analysis of observational studies. We achieved a MEDLINE/EMBASE comprehensive search for studies published up to August 2014 investigating the association between use of statins and the risk of hematological malignancies, including Hodgkin- and non-Hodgkin lymphoma, leukemia, and myeloma. Fixed- and random-effect models were fitted to estimate the summary relative risk (RR) based on adjusted study-specific results. Between-study heterogeneity was assessed using the Q and I(2) statistics and the sources of heterogeneity were investigated using Deeks' test. Moreover, an influence analysis was performed. Finally, publication bias was evaluated using funnel plot and Egger's regression asymmetry test. Fourteen studies (10 case-control and four cohort studies) contributed to the analysis. Statin use, compared to nonuse of statins, was negatively associated with all hematological malignancies taken together (summary RR 0.86; 95% CI: 0.77-0.96), with leukemia (0.83; 0.74-0.92), and non-Hodgkin lymphoma (0.81; 0.68 to 0.96), but it was not related to the risk of myeloma (0.89; 0.53-1.51). Long-term users of statins showed a statistically significant reduction in the risk of all hematological malignancies taken together (0.78; 0.71-0.87). Statistically significant between-studies heterogeneity was observed for all outcome except for leukemia. Heterogeneity was caused by differences confounding-adjustment level of the included studies only for Myeloma. No significant evidence of publication bias was found.
为了量化他汀类药物的使用与所有血液系统恶性肿瘤及其亚型风险之间的关联，我们对观察性研究进行了荟萃分析。我们对截至2014年8月发表的研究进行了MEDLINE/EMBASE全面检索，以调查他汀类药物的使用与血液系统恶性肿瘤风险之间的关联，包括霍奇金淋巴瘤和非霍奇金淋巴瘤、白血病和骨髓瘤。基于各研究经调整后的特定结果，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）。使用Q统计量和I²统计量评估研究间的异质性，并使用Deeks检验调查异质性来源。此外，还进行了影响分析。最后，使用漏斗图和Egger回归不对称检验评估发表偏倚。14项研究（10项病例对照研究和4项队列研究）纳入了分析。与未使用他汀类药物相比，使用他汀类药物与所有血液系统恶性肿瘤的综合风险呈负相关（汇总RR 0.86；95%CI：0.77 - 0.96），与白血病（0.83；0.74 - 0.92）和非霍奇金淋巴瘤（0.81；0.68至0.96）相关，但与骨髓瘤风险无关（0.89；0.53 - 1.51）。他汀类药物的长期使用者在所有血液系统恶性肿瘤综合风险方面显示出统计学上的显著降低（0.78；0.71 - 0.87）。除白血病外，所有结局均观察到研究间存在统计学上的显著异质性。异质性仅由纳入研究的混杂因素调整水平差异导致骨髓瘤出现。未发现明显的发表偏倚证据。
