非甾体类抗炎药对肝细胞癌发生及复发风险的影响：一项荟萃分析
The effects of nonsteroidal anti-inflammatory drugs in the incident and recurrent risk of hepatocellular carcinoma: a meta-analysis.
作者信息
Pang Qing, Jin Hao, Qu Kai, Man Zhongran, Wang Yong, Yang Song, Zhou Lei, Liu Huichun
机构信息
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
出版信息
Onco Targets Ther. 2017 Sep 20;10:4645-4656. doi: 10.2147/OTT.S143154. eCollection 2017.
BACKGROUND
Recent studies have showed that nonsteroidal anti-inflammatory drugs (NSAIDs) could reduce the risk of several types of cancer. However, epidemiological evidence of the association between NSAIDs intake and the risk of hepatocellular carcinoma (HCC) remains controversial.
METHODS
To assess the preventive benefit of NSAIDs in HCC, we simultaneously searched the databases of PubMed, EmBase, Web of Science, and Scopus and screened eligible publications.
RESULTS
A total of twelve articles (published from 2000 to 2017) from five countries were identified by retrieval. We observed a significantly lower risk of HCC incidence among users of NSAIDs than among those who did not use NSAIDs (pooled hazard ratio [HR] value =0.81, 95% confidence interval [CI]: 0.69-0.94). No evidence of publication bias was observed (Begg's test, =0.755; Egger's test, =0.564). However, when stratified according to the categories of NSAIDs, users of non-aspirin NSAIDs (HR =0.81, 95% CI: 0.70-0.94), but not aspirin (HR =0.77, 95% CI: 0.58-1.02), showed a statistically significant reduced HCC incidence. We also found that NSAIDs use significantly reduced the recurrent risk of HCC, with a HR value of 0.79 (95% CI: 0.75-0.84), whereas there was no statistically significant association between NSAIDs use and HCC mortality, with a HR value 0.65 (95% CI: 0.40-1.06).
CONCLUSION
Taken together, our meta-analysis demonstrates that NSAIDs significantly reduce the incident and recurrent risk of HCC.
背景
近期研究表明，非甾体抗炎药（NSAIDs）可降低多种癌症的风险。然而，NSAIDs摄入与肝细胞癌（HCC）风险之间关联的流行病学证据仍存在争议。
方法
为评估NSAIDs对HCC的预防作用，我们同时检索了PubMed、EmBase、Web of Science和Scopus数据库，并筛选符合条件的出版物。
结果
通过检索共确定了来自五个国家的12篇文章（发表于2000年至2017年）。我们观察到，NSAIDs使用者发生HCC的风险显著低于未使用NSAIDs者（合并风险比[HR]值 =0.81，95%置信区间[CI]：0.69 - 0.94）。未观察到发表偏倚的证据（Begg检验，P =0.755；Egger检验，P =0.564）。然而，根据NSAIDs类别进行分层时，非阿司匹林类NSAIDs使用者（HR =0.81，95%CI：0.70 - 0.94），而非阿司匹林使用者（HR =0.77，95%CI：0.58 - 1.02），显示HCC发病率有统计学意义的降低。我们还发现，使用NSAIDs可显著降低HCC的复发风险，HR值为0.79（95%CI：0.75 - 0.84），而使用NSAIDs与HCC死亡率之间无统计学意义的关联，HR值为0.65（95%CI：0.40 - 1.06）。
结论
综合来看，我们的荟萃分析表明，NSAIDs可显著降低HCC的发病和复发风险。
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