Yang Jing, Li Chunyu, Shen Ying, Zhou Hong, Shao Yueqin, Zhu Wei, Chen Yan
Oncology Center, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Wujiang.
Intensive Care Unit, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu.
Medicine (Baltimore). 2020 Apr;99(14):e19596. doi: 10.1097/MD.0000000000019596.
This meta-analysis mainly summarized the studies reporting an association between statin use and cancer-specific mortality and recurrence or progression of cancer patients.We systematically searched for studies about the statin used in cancer patients in electronic databases, including PubMed, Web of Science, Cochrane, Clinical Trials, from inception through the November 2019. A total of 60 studies which included 953,177 participants were eligible with 233,322 cancer patients used statin. Our analysis selected studies presented with outcome based on hazard ratios (HRs) and 95% confidence intervals (CIs) of cancer-specific mortality and cancer recurrence-free survival or progression-free survival. Heterogeneity between the studies was examined using I statistics, and sensitivity analyses were conducted to assess the robustness of the findings. All statistical analyses were performed using RevMan software (version 5.3).The use of statin was potentially associated with a decline in cancer-specific mortality in cancer patients (HR = 0.78; 95% CI: 0.74, 0.84; n = 39; I = 85%). Furthermore, statin use was associated with improved recurrence-free survival (HR = 0.87; 95% CI: 0.78,0.97; n = 23; I = 64%), but not with improvement in progression-free survival (HR = 1.05; 95% CI: 0.95,1.16; n = 14; I2 = 38%).The meta-analysis demonstrated that statin use could exhibit potential survival benefit in the prognosis of cancer patients. But our results are conservative for statins to improve disease recurrence and progression. These findings should be assessed in a prospective randomized cohort.
本荟萃分析主要总结了报告他汀类药物使用与癌症患者癌症特异性死亡率及癌症复发或进展之间关联的研究。我们在电子数据库中系统检索了关于癌症患者使用他汀类药物的研究，数据库包括PubMed、科学网、考克兰图书馆、临床试验数据库，检索时间从建库至2019年11月。共有60项研究符合条件，涉及953,177名参与者，其中233,322名癌症患者使用了他汀类药物。我们的分析选择了基于癌症特异性死亡率及无癌复发生存期或无进展生存期的风险比（HRs）和95%置信区间（CIs）呈现结果的研究。使用I统计量检验研究之间的异质性，并进行敏感性分析以评估研究结果的稳健性。所有统计分析均使用RevMan软件（5.3版）进行。他汀类药物的使用可能与癌症患者癌症特异性死亡率的降低相关（HR = 0.78；95% CI：0.74, 0.84；n = 39；I² = 85%）。此外，他汀类药物的使用与无复发生存期的改善相关（HR = 0.87；95% CI：0.78, 0.97；n = 23；I² = 64%），但与无进展生存期的改善无关（HR = 1.05；95% CI：0.95, 1.16；n = 14；I² = 38%）。荟萃分析表明，他汀类药物的使用在癌症患者的预后中可能具有潜在的生存益处。但我们的结果对于他汀类药物改善疾病复发和进展而言较为保守。这些发现应在前瞻性随机队列中进行评估。
