Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China.
Int Braz J Urol. 2018 Sep-Oct;44(5):865-873. doi: 10.1590/S1677-5538.IBJU.2017.0531.
To assess the relationship between 5α-reductase inhibitors (5ARIs) and the risk of male breast cancer (MBC).
We systematically searched Medline via PubMed, Embase and the Cochrane Library Central Register up to May 2017 to identify published articles related to 5ARIs and the risk of MBC.
Summary effect estimates were calculated by a random-effect model, and tests for multivariable-unadjusted pooled risk ratios (RR) and heterogeneity, as well as the sensitivity analyses were conducted to assess publication bias. All four studies were conducted in a quality assessment according to the Newcastle Ottawa Scale system. The strength of association between 5ARIs and the prevalence of MBC was evaluated by using summarized unadjusted pooled RR with a 95% confidence interval [CI]. Four studies involving 595.776 participants, mean age range from 60 to 73.2 years old, were included in a meta-analysis, which produced a summary unadjusted RR of the risk of MBC for the treatment of 5ARIs of 1.16 (95% CI 0.85-1.58, P=0.36) and the multivariable-adjusted RR is 1.03, (95% CI 0.75-1.41, p=0.86). There was no heterogeneity among included studies (I2=0%, P=0.49). Estimates of total effects were generally consistent with the sensitivity.
We did not observe a positive association between the use of 5ARIs and MBC. The small number of breast cancer cases exposed to 5ARIs and the lack of na association in our study suggest that the development of breast cancer should not influence the prescribing of 5ARIs therapy.
评估 5α-还原酶抑制剂（5ARIs）与男性乳腺癌（MBC）风险之间的关系。
我们通过 PubMed、Embase 和 Cochrane 图书馆中央注册系统系统地搜索了截至 2017 年 5 月发表的相关文章，以确定与 5ARIs 和 MBC 风险相关的文章。
采用随机效应模型计算汇总效应估计值，并进行多变量未调整汇总风险比（RR）和异质性检验，以及敏感性分析以评估发表偏倚。根据 Newcastle-Ottawa 量表系统对所有四项研究进行质量评估。使用汇总未调整的 RR 及其 95%置信区间[CI]评估 5ARIs 与 MBC 患病率之间的关联强度。四项研究共纳入 595.776 名参与者，平均年龄 60-73.2 岁，进行荟萃分析，结果显示，5ARIs 治疗 MBC 的未调整汇总 RR 为 1.16（95%CI 0.85-1.58，P=0.36），多变量调整后的 RR 为 1.03（95%CI 0.75-1.41，p=0.86）。纳入研究之间无异质性（I2=0%，P=0.49）。总效应的估计值与敏感性分析基本一致。
我们没有观察到 5ARIs 的使用与 MBC 之间存在正相关关系。暴露于 5ARIs 的乳腺癌病例数量较少，且本研究中无相关性，这表明乳腺癌的发生不应影响 5ARIs 治疗的处方。
