诊断后使用β受体阻滞剂与卵巢癌预后：对11项队列研究中20274例患者的系统评价和荟萃分析
Post-Diagnostic Beta Blocker Use and Prognosis of Ovarian Cancer: A Systematic Review and Meta-Analysis of 11 Cohort Studies With 20,274 Patients.
作者信息
Wen Zhao-Yan, Gao Song, Gong Ting-Ting, Jiang Yu-Ting, Zhang Jia-Yu, Zhao Yu-Hong, Wu Qi-Jun
机构信息
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
Front Oncol. 2021 Jun 17;11:665617. doi: 10.3389/fonc.2021.665617. eCollection 2021.
OBJECTIVES
Previous experimental studies have indicated that exposure to beta blocker provides protective effects against ovarian cancer (OC). However, findings from epidemiologic studies have still been controversial. Therefore, we carried out a meta-analysis to update and quantify the correlation between post-diagnostic beta blocker usage and OC prognosis.
METHODS
The meta-analysis had been registered at PROSPEPO. The number of registration is CRD42020188806. A comprehensive search of available literatures in English prior to April 16, 2020, was conducted in PubMed, EMBASE, and the Web of Science databases. Random-effects models were used to calculate overall hazard ratios (HRs) and 95% confidence intervals (CIs). Publication bias assessments, and subgroup, sensitivity, and meta-regression analyses were also performed.
RESULTS
Of the 637 initially identified articles, 11 retrospective cohort studies with 20,274 OC patients were included. The summary HRs did not reveal any statistically significant associations between post-diagnostic beta blocker use and OC prognosis characteristics, such as total mortality (HR = 1.08, 95% CI = 0.92-1.27, = 76.5%, n = 9), cancer-specific mortality (HR = 1.22, 95% CI = 0.89-1.67, = 88.1%, n=3), and progression-free survival (HR = 0.88, 95% CI = 0.75-1.05, = 0, n = 4). No evidence of publication bias was observed in current analysis. In our subgroup analyses, the majority of results were consistent with the main findings. However, several positive correlations were detected in studies with ≥800 cases (HR = 1.20, 95% CI = 1.05-1.37), no immortal time bias (HR = 1.28, 95% CI = 1.10-1.49), and adjustment for comorbidity (HR = 1.20, 95% CI = 1.05-1.37). In the meta-regression analysis, no evidence of heterogeneity was detected in the subgroups according to study characteristics and confounding factors.
CONCLUSIONS
Post-diagnostic beta blocker use has no statistical correlation with OC prognosis. More prospective cohort studies are necessary to further verify our results.
SYSTEMATIC REVIEW REGISTRATION
Identifier (CRD42020188806).
目的
既往实验研究表明，使用β受体阻滞剂对卵巢癌（OC）具有保护作用。然而，流行病学研究的结果仍存在争议。因此，我们进行了一项荟萃分析，以更新和量化诊断后使用β受体阻滞剂与OC预后之间的相关性。
方法
该荟萃分析已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为CRD42020188806。于2020年4月16日前在PubMed、EMBASE和Web of Science数据库中全面检索了英文文献。采用随机效应模型计算总体风险比（HR）和95%置信区间（CI）。还进行了发表偏倚评估以及亚组分析、敏感性分析和meta回归分析。
结果
在最初识别出的637篇文章中，纳入了11项回顾性队列研究，共20274例OC患者。汇总的HR未显示诊断后使用β受体阻滞剂与OC预后特征之间存在任何统计学上的显著关联，如总死亡率（HR = 1.08，95%CI = 0.92 - 1.27，I² = 76.5%，n = 9）、癌症特异性死亡率（HR = 1.22，95%CI = 0.89 - 1.67，I² = 88.1%，n = 3）和无进展生存期（HR = 0.88，95%CI = 0.75 - 1.05，I² = 0，n = 4）。当前分析未观察到发表偏倚的证据。在我们的亚组分析中，大多数结果与主要发现一致。然而，在病例数≥800例的研究（HR = 1.20，95%CI = 1.05 - 1.37）、无永生时间偏倚的研究（HR = 1.28，95%CI = 1.10 - 1.49）以及对合并症进行调整的研究（HR = 1.20，95%CI = 1.05 - 1.37）中检测到了一些正相关。在meta回归分析中，根据研究特征和混杂因素，亚组中未检测到异质性证据。
结论
诊断后使用β受体阻滞剂与OC预后无统计学相关性。需要更多的前瞻性队列研究来进一步验证我们的结果。
系统评价注册
标识符（CRD42020188806）
Zotero 插件