Islam Md Mohaimenul, Poly Tahmina Nasrin, Walther Bruno Andreas, Yang Hsuan-Chia, Jack Li Yu-Chuan
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan.
International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei 110, Taiwan.
Cancers (Basel). 2020 Mar 13;12(3):671. doi: 10.3390/cancers12030671.
: Statins are the first-line medication to treating hypercholesterolemia. Several studies have investigated the impact of statins on the risk of hepatocellular carcinoma (HCC). However, the extent to which statins may prevent HCC remains uncertain. Therefore, we performed a meta-analysis of relevant studies to quantify the magnitude of the association between statins use and the risk of HCC. A systematic literature search of PubMed, EMBASE, Google Scholar, Web of Science, and Scopus was performed for studies published between January 1, 1990, and September 1, 2019, with no restriction of language. Two reviewers independently evaluated the literature and included observational and experimental studies that reported the association between statin use and HCC risk. The random-effect model was used to calculate the overall risk ratio (RR) with a 95% confidence interval (CI), and the heterogeneity among the studies was assessed using the statistic and statistic. The Newcastle Ottawa Scale (NOS) was also used to evaluate the quality of the included studies. A total of 24 studies with 59,073 HCC patients was identified. Statin use was associated with a reduced risk of HCC development (RR: 0.54, 95% CI: 0.47-0.61, = 84.39%) compared with nonusers. Moreover, the rate of HCC reduction was also significant among patients with diabetes (RR: 0.44, 95% CI: 0.28-0.70), liver cirrhosis (RR: 0.36, 95% CI: 0.30-0.42), and antiviral therapy (RR: 0.21, 95% CI: 0.08-0.59) compared with nonusers. : This study serves as additional evidence supporting the beneficial inhibitory effect of statins on HCC incidence. The subgroup analyses of this study also highlight that statins are significantly associated with a reduced risk of HCC and may help to direct future prevention efforts. Additional large clinical studies are needed to determine whether statins are associated with a lower risk of HCC.
他汀类药物是治疗高胆固醇血症的一线药物。多项研究调查了他汀类药物对肝细胞癌（HCC）风险的影响。然而，他汀类药物预防HCC的程度仍不确定。因此，我们对相关研究进行了荟萃分析，以量化他汀类药物使用与HCC风险之间关联的程度。我们对PubMed、EMBASE、谷歌学术、科学网和Scopus进行了系统的文献检索，以查找1990年1月1日至2019年9月1日发表的研究，不限语言。两名评审员独立评估文献，并纳入报告他汀类药物使用与HCC风险之间关联的观察性和实验性研究。采用随机效应模型计算总体风险比（RR）及95%置信区间（CI），并使用I²统计量和τ²统计量评估研究间的异质性。还使用纽卡斯尔渥太华量表（NOS）评估纳入研究的质量。共确定了24项研究，涉及59073例HCC患者。与未使用者相比，使用他汀类药物与HCC发生风险降低相关（RR：0.54，95%CI：0.47 - 0.61，I² = 84.39%）。此外，与未使用者相比，糖尿病患者（RR：0.44，95%CI：0.28 - 0.70）、肝硬化患者（RR：0.36，95%CI：0.30 - 0.42）和接受抗病毒治疗患者（RR：0.21，95%CI：0.08 - 0.59）的HCC降低率也显著。：本研究为支持他汀类药物对HCC发病率的有益抑制作用提供了额外证据。本研究的亚组分析还突出表明，他汀类药物与HCC风险降低显著相关，可能有助于指导未来的预防工作。需要更多大型临床研究来确定他汀类药物是否与较低的HCC风险相关。
