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他汀类药物的使用与非黑色素瘤皮肤癌风险：一项对随机对照试验和观察性研究的荟萃分析。

Statin use and non-melanoma skin cancer risk: a meta-analysis of randomized controlled trials and observational studies.

作者信息

Yang Keming, Marley Andrew, Tang Huilin, Song Yiqing, Tang Jean Y, Han Jiali

机构信息

Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN 46202-2872, USA.

Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94063, USA.

出版信息

Oncotarget. 2017 Aug 8;8(43):75411-75417. doi: 10.18632/oncotarget.20034. eCollection 2017 Sep 26.

DOI:10.18632/oncotarget.20034
PMID:29088876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5650431/
Abstract

BACKGROUND

Existing evidence of the association between statin use and non-melanoma skin cancer (NMSC) risk has been inconsistent.

OBJECTIVE

To maximize statistical power to synthesize prospective evidence on this relationship.

MATERIALS AND METHODS

PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrial.gov were systematically searched up to December 11, 2016. A random-effects meta-analysis was conducted to calculate summary estimates.

RESULTS

Our meta-analysis of 14 randomized controlled trials (RCTs) including 63,157 subjects showed no significant association between statin use and NMSC risk (RR = 1.09, 95%CI = 0.85-1.39). However, meta-analysis of four observational studies including 1,528,215 participants showed significantly increased risk of NMSC among statin users compared to non-users (RR = 1.11, 95%CI = 1.02-1.22). Furthermore, ever using lipophilic statins (RR = 1.14, 95%CI = 1.04-1.24) or lower-potency statins (RR = 1.14, 95%CI = 1.03-1.26), as well as usage of any statin longer than one year (RR = 1.14, 95%CI = 1.09-1.18) were significantly associated with increased NMSC risk based on observational studies.

CONCLUSIONS

Evidence from observational studies supported an association between statin use and increased NMSC risk. This finding should be interpreted with caution due to modest number of included studies, possible between-study heterogeneity and inherent limitations of observational studies.

摘要

背景

他汀类药物使用与非黑色素瘤皮肤癌（NMSC）风险之间关联的现有证据并不一致。

目的

最大限度地提高统计效能，以综合关于这种关系的前瞻性证据。

材料与方法

截至2016年12月11日，系统检索了PubMed、EMBASE、科学网、Cochrane对照试验中心注册库和ClinicalTrial.gov。进行随机效应荟萃分析以计算汇总估计值。

结果

我们对14项随机对照试验（RCT）（包括63157名受试者）的荟萃分析显示，他汀类药物使用与NMSC风险之间无显著关联（风险比[RR]=1.09，95%置信区间[CI]=0.85-1.39）。然而，对4项观察性研究（包括1528215名参与者）的荟萃分析显示，与未使用者相比，他汀类药物使用者的NMSC风险显著增加（RR=1.11，95%CI=1.02-1.22）。此外，基于观察性研究，曾经使用亲脂性他汀类药物（RR=1.14，95%CI=1.04-1.24）或低强度他汀类药物（RR=1.14，95%CI=1.03-1.26），以及使用任何他汀类药物超过一年（RR=1.14，95%CI=1.09-1.18）均与NMSC风险增加显著相关。

结论

观察性研究的证据支持他汀类药物使用与NMSC风险增加之间存在关联。由于纳入研究数量有限、研究间可能存在异质性以及观察性研究的固有局限性，这一发现应谨慎解读。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaee/5650431/ba4f06e0d62e/oncotarget-08-75411-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaee/5650431/20757fe3dc6c/oncotarget-08-75411-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaee/5650431/ba4f06e0d62e/oncotarget-08-75411-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaee/5650431/20757fe3dc6c/oncotarget-08-75411-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaee/5650431/ba4f06e0d62e/oncotarget-08-75411-g002.jpg

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