Mao Yeqing, Xu Xin, Wang Xiao, Zheng Xiangyi, Xie Liping
Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Oncotarget. 2016 Feb 9;7(6):6765-73. doi: 10.18632/oncotarget.6837.
Emerging evidence suggests that renin-angiotensin system (RAS) may act as a molecular and therapeutic target for treating site-specific cancers, including prostate cancer. However, previous observational studies regarding the association between RAS inhibitors and prostate cancer risk have reported inconsistent results. We examined this association by performing a systematic review and meta-analysis. A total of 20,267 patients from nine cohort studies were enrolled. Compared with non-users of RAS inhibitors, individuals using RAS inhibitors had a reduced risk of prostate cancer (RR 0.92, 95 % CI 0.87-0.98), without statistically significant heterogeneity among studies (P = 0.118 for heterogeneity, I2 = 37.6 %). In addition, when subgroup analyses by study quality and number of cases, more statistically significant associations were observed in studies of high quality (RR 0.93, 95 % CI 0.88-0.97) and large sample size (RR 0.94, 95 % CI 0.91-0.98). There was no evidence of significant publication bias with Begg's test (P = 0.602) or with Egger's test (P = 0.350). Overall, this study indicates that use of RAS inhibitors may be associated with a decreased risk of prostate cancer. Large-scale well designed studies are needed to further explore this association.
新出现的证据表明，肾素-血管紧张素系统（RAS）可能作为治疗包括前列腺癌在内的特定部位癌症的分子和治疗靶点。然而，先前关于RAS抑制剂与前列腺癌风险之间关联的观察性研究报告的结果并不一致。我们通过进行系统评价和荟萃分析来研究这种关联。总共纳入了来自9项队列研究的20267例患者。与未使用RAS抑制剂的个体相比，使用RAS抑制剂的个体患前列腺癌的风险降低（风险比0.92，95%置信区间0.87-0.98），各研究之间无统计学显著异质性（异质性P=0.118，I²=37.6%）。此外，按研究质量和病例数进行亚组分析时，在高质量研究（风险比0.93，95%置信区间0.88-0.97）和大样本量研究（风险比0.94，95%置信区间0.91-0.98）中观察到更具统计学显著性的关联。Begg检验（P=0.602）或Egger检验（P=0.350）均未显示有显著发表偏倚的证据。总体而言，本研究表明使用RAS抑制剂可能与前列腺癌风险降低有关。需要开展大规模精心设计的研究来进一步探索这种关联。
