Department of Gynecology, West China Second Hospital, Sichuan University, 610011 Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China.
Department of Gynecology, West China Second Hospital, Sichuan University, 610011 Chengdu, Sichuan, China.
Eur J Obstet Gynecol Reprod Biol. 2022 Jan;268:74-81. doi: 10.1016/j.ejogrb.2021.11.013. Epub 2021 Nov 12.
Recent evidence has demonstrated that the salutary effect of statins on the prevention and prognosis of cancers, including gynecologic cancers. However, due to the heterogeneity of tumors, the results from related studies regarding the association between statin therapy and gynecologic cancers are conflicting. Thus, we conducted this meta-analysis to better understand the relationship between statins use and gynecologic cancers.
We searched for articles published before July 2021 in the databases: PubMed, Web of Science, Medline, EMBASE and Google Scholar. We computed odds ratio (OR)/relative risk (RR) or hazard ratio (HR) and 95% confidence intervals (CI) regarding the association between statin use and the risk or prognosis of gynecologic cancers by using STATA 12.0 software.
The present meta-analysis showed that statin use was associated with a lower risk of gynecologic cancer (OR/RR = 0.89, 95% CI 0.83 to 0.96, I = 60.6%, p < 0.001). Statin use was associated with lower risks of endometrial cancer and ovarian cancer (endometrial cancer: OR/RR = 0.81, 95% CI 0.70 to 0.94, I = 62.3%, p = 0.001; ovarian cancer: OR/RR = 0.92, 95% CI 0.85 to 1.00, I = 42.1%, p = 0.077). The present meta-analysis showed that statin use was associated with a lower mortality of gynecologic cancer (HR = 0.73, 95% CI 0.67 to 0.80, I = 39.0%, p = 0.03). Statin use was associated with lower mortalities of endometrial cancer and ovarian cancer (endometrial cancer: HR = 0.71, 95% CI 0.64 to 0.80, I = 31.9%, p = 0.144; ovarian cancer: HR = 0.78, 95% CI 0.73 to 0.83, I = 43.9%, p = 0.051).
Statins use was inversely associated with the risk and mortality of gynecologic cancers. Meanwhile, we need more well-designed and high-quality studies with strong evidence for definite conclusions that determine clinical practice.
最近的证据表明,他汀类药物对预防和预后癌症(包括妇科癌症)具有有益作用。然而,由于肿瘤的异质性,关于他汀类药物治疗与妇科癌症之间关联的相关研究结果存在冲突。因此,我们进行了这项荟萃分析,以更好地了解他汀类药物使用与妇科癌症之间的关系。
我们在数据库 PubMed、Web of Science、Medline、EMBASE 和 Google Scholar 中检索了截至 2021 年 7 月之前发表的文章。我们使用 STATA 12.0 软件计算了与他汀类药物使用与妇科癌症风险或预后相关的比值比(OR)/相对风险(RR)或风险比(HR)和 95%置信区间(CI)。
本荟萃分析表明,他汀类药物使用与妇科癌症风险降低相关(OR/RR=0.89,95%CI 0.83 至 0.96,I=60.6%,p<0.001)。他汀类药物使用与子宫内膜癌和卵巢癌风险降低相关(子宫内膜癌:OR/RR=0.81,95%CI 0.70 至 0.94,I=62.3%,p=0.001;卵巢癌:OR/RR=0.92,95%CI 0.85 至 1.00,I=42.1%,p=0.077)。本荟萃分析表明,他汀类药物使用与妇科癌症死亡率降低相关(HR=0.73,95%CI 0.67 至 0.80,I=39.0%,p=0.03)。他汀类药物使用与子宫内膜癌和卵巢癌死亡率降低相关(子宫内膜癌:HR=0.71,95%CI 0.64 至 0.80,I=31.9%,p=0.144;卵巢癌:HR=0.78,95%CI 0.73 至 0.83,I=43.9%,p=0.051)。
他汀类药物使用与妇科癌症的风险和死亡率呈负相关。同时,我们需要更多设计良好、高质量且具有强证据的研究来确定临床实践。