Khazaaleh Shrouq, Sarmini Muhammad Talal, Alomari Mohammad, Al Momani Laith, El Kurdi Bara, Asfari Mohammad, Almomani Zain, Romero-Marrero Carlos
Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, USA.
Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, USA.
Cureus. 2022 Jul 19;14(7):e27032. doi: 10.7759/cureus.27032. eCollection 2022 Jul.
Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver resulting in approximately 800,000 deaths annually. A growing body of research investigating statin use and HCC risk has shown conflicting results. We aim to evaluate the current evidence of statin impact on HCC risk. We performed a comprehensive literature search in PubMed, PubMed Central, Embase, and ScienceDirect databases from inception through May 2019 to identify all studies that evaluated the association between statin use and HCC. We included studies that presented an odds ratio (OR) with a 95% confidence interval (CI) or presented data sufficient to calculate the OR with a 95% CI. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA), Version 3 software, and a Forrest plot was generated. We assessed for publication bias using conventional techniques. Twenty studies (three randomized controlled trials, six cohorts, and 11 case-controls) with 2,668,497 patients including 24,341 cases of HCC were included in the meta-analysis. Our findings indicate a significant risk reduction of HCC among all statin users with a pooled odds ratio of 0.573 (95% CI: 0.491-0.668, I2= 86.57%) compared to non-users. No publication bias was found using Egger's regression test or on visual inspection of the generated Funnel plot. The results indicate that statin use was associated with a 43% lower risk of HCC compared to statin non-users. Further prospective randomized research is needed to confirm the association.
肝细胞癌（HCC）是最常见的原发性肝脏肿瘤，每年导致约80万人死亡。越来越多关于他汀类药物使用与HCC风险的研究结果相互矛盾。我们旨在评估目前关于他汀类药物对HCC风险影响的证据。我们在PubMed、PubMed Central、Embase和ScienceDirect数据库中进行了全面的文献检索，检索时间从数据库建立至2019年5月，以识别所有评估他汀类药物使用与HCC之间关联的研究。我们纳入了呈现比值比（OR）及95%置信区间（CI）或提供足以计算OR及95%CI的数据的研究。使用综合荟萃分析（CMA）3.0软件进行统计分析，并生成森林图。我们使用传统技术评估发表偏倚。荟萃分析纳入了20项研究（3项随机对照试验、6项队列研究和11项病例对照研究），共2668497例患者，其中包括24341例HCC病例。我们的研究结果表明，与未使用他汀类药物的患者相比，所有使用他汀类药物的患者发生HCC的风险显著降低，合并比值比为0.573（95%CI：0.491 - 0.668，I2 = 86.57%）。使用Egger回归检验或对生成的漏斗图进行视觉检查均未发现发表偏倚。结果表明，与未使用他汀类药物的患者相比，使用他汀类药物可使HCC风险降低43%。需要进一步的前瞻性随机研究来证实这种关联。
