血管紧张素转化酶抑制剂和血管紧张素受体阻滞剂在肾癌治疗中的治疗选择：一项荟萃分析。

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers as therapeutic options in the treatment of renal cancer: A meta-analysis.

机构信息

Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Iranshahr University of Medical Sciences, Iranshahr, Iran; Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Life Sci. 2020 Feb 1;242:117181. doi: 10.1016/j.lfs.2019.117181. Epub 2019 Dec 18.

DOI:10.1016/j.lfs.2019.117181

PMID:31863771

Abstract

AIMS

Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) which have been used in the treatment of cardiovascular diseases, have also been shown to have anti-tumor effects against various cancers that include renal cancer. The aim of current paper was to explore the potential clinical impact of ACEI/ARB inhibitors in renal cancer.

MAIN METHODS

We used several databases: EMBASE, PubMed and the Cochrane library, to identify clinical studies that assessed the relationship between ACEIs/ARBs treatment and risk of renal cancer incidence or survival of renal cancer patients. The hazard ratio (HR) with 95% confidence intervals were obtained for assessing the relationship between ACEIs/ARBs and renal cancer mortality.

KEY FINDING

The HR for the relationship between ASIs use and survival of renal cancer indicated that patients with renal cancer being treated with ACEIs/ARBs had a significantly lower mortality than non-user (HR 0.723, 95% CI 0.568-0.921, p = 0.009). The HR for the relationship between ACEIs use and survival of renal cancer indicated that patients with renal cancer that used ACEIs had a higher mortality than non-users (HR 1.352, 95% CI 0.917-1.991, p = 0.128). The HR for the relationship between ARBs use and survival of renal cancer indicated that patients with renal cancer that used ARBs had a decreased of mortality than non-users (HR 0.818, 95% CI 0.691-0.969, p = 0.02).

SIGNIFICANCE

This meta-analysis demonstrated that treatment with ACEIs/ARBs may improve renal cancer survival and reduce the mortality of patients with renal cancer.

摘要

目的

血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）已被用于治疗心血管疾病，也已被证明对包括肾癌在内的各种癌症具有抗肿瘤作用。本文旨在探讨 ACEI/ARB 抑制剂在肾癌中的潜在临床影响。

方法

我们使用了几个数据库：EMBASE、PubMed 和 Cochrane 图书馆，以确定评估 ACEIs/ARBs 治疗与肾癌发病率或肾癌患者生存风险之间关系的临床研究。使用风险比（HR）和 95%置信区间来评估 ACEIs/ARBs 与肾癌死亡率之间的关系。

主要发现

ASIs 使用与肾癌生存之间的 HR 表明，接受 ACEIs/ARBs 治疗的肾癌患者死亡率明显低于未使用者（HR 0.723，95%CI 0.568-0.921，p=0.009）。ACEIs 使用与肾癌生存之间的 HR 表明，使用 ACEIs 的肾癌患者死亡率高于未使用者（HR 1.352，95%CI 0.917-1.991，p=0.128）。ARBs 使用与肾癌生存之间的 HR 表明，使用 ARBs 的肾癌患者死亡率低于未使用者（HR 0.818，95%CI 0.691-0.969，p=0.02）。