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他汀类药物治疗能否降低肝细胞癌风险?系统评价和荟萃分析。

Can Statin Treatment Reduce the Risk of Hepatocellular Carcinoma? A Systematic Review and Meta-Analysis.

机构信息

Department of Hepatopancreatobiliary and Splenic Medicine, Characteristic Medical Center of People's Armed Police Force, Tianjin, China.

Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis and Treatment, Tianjin, China.

出版信息

Technol Cancer Res Treat. 2020 Jan-Dec;19:1533033820934881. doi: 10.1177/1533033820934881.

Abstract

BACKGROUND

Whether statins can reduce the incidence of cancers has been an interesting topic in recent years. This meta-analysis aimed to determine the relationship between statin treatment with the risk of hepatocellular carcinoma.

METHODS

Studies published up to July 2019 were screened from databases. The data from approved studies were pooled. Random-effects or fixed-effects model was used to calculate the relative risk with 95% CIs in the overall group and subgroups. Sensitivity and meta-regression analyses were performed, and publication bias was evaluated.

RESULTS

A total of 18 studies involving 1 611 596 patients were included in this meta-analysis. The overall result showed a significantly reduced risk of hepatocellular carcinoma (relative risk = 0.54, 95% CI: 0.42-0.66) in statin users. In comparison to the risk in nonstatin users, the risk of hepatocellular carcinoma was reduced in all subgroups. The dose of statins and their pharmacokinetics can partly explain the heterogeneity in the overall meta-analysis ( = 94.6%, = .000). A dose-dependent effect of statin use for the reduced risk of hepatocellular carcinoma was found.

CONCLUSIONS

Findings from this meta-analysis support that statin use can significantly reduce the incidence of hepatocellular carcinoma.

摘要

背景

他汀类药物是否能降低癌症的发病率一直是近年来一个很有趣的话题。本荟萃分析旨在确定他汀类药物治疗与肝细胞癌风险之间的关系。

方法

从数据库中筛选出截至 2019 年 7 月发表的研究。合并经证实研究的数据。采用随机效应或固定效应模型计算汇总组和亚组的相对风险(RR)及其 95%置信区间(CI)。进行敏感性和荟萃回归分析,并评估发表偏倚。

结果

共纳入 18 项研究,涉及 1611596 例患者。整体结果显示,他汀类药物使用者肝细胞癌的发病风险显著降低(RR=0.54,95%CI:0.42-0.66)。与非他汀类药物使用者相比,所有亚组的肝细胞癌发病风险均降低。他汀类药物的剂量及其药代动力学可部分解释总体荟萃分析中的异质性( = 94.6%, =.000)。发现他汀类药物使用对降低肝细胞癌风险存在剂量依赖性效应。

结论

本荟萃分析结果支持他汀类药物的使用能显著降低肝细胞癌的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a05/7307281/2cb4d5dd9d88/10.1177_1533033820934881-fig1.jpg

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