Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 100191, Beijing, P. R. China.
Peking University Health Science Center, Peking University, 100191, Beijing, P. R. China.
Br J Cancer. 2023 Jan;128(2):168-176. doi: 10.1038/s41416-022-02029-5. Epub 2022 Nov 17.
The association between the use of angiotensin-converting enzyme inhibitors (ACEIs) and lung cancer risk remains controversial. This study evaluated the association between the use of ACEIs and lung cancer risk.
Records from five databases were searched from inception to 26 January 2022. Clinical studies involving persons aged ≥18 years with at least one year of follow-up and reporting adverse events, including lung cancer, were recorded with separate outcome reports supplied for the ACEIs and control groups. Data were extracted independently by three authors and pooled using a random-effects model. The primary outcome was lung cancer development. Odds ratios (ORs) with 95% confidence intervals (CIs) and lung cancer-related morbidity were calculated.
Of 2400 records screened, 13,061,226 patients were included from seven cohort studies and four case-control studies. Pooled results showed that ACEIs use was linked to increased lung cancer risk (OR 1.19, 95% CI 1.05-1.36; P = 0.008), with high heterogeneity (I = 98%).
ACEI usage is a greater risk factor for lung carcinogenesis than angiotensin receptor blocker use, especially in Asian patients. Further randomised controlled trials are needed to confirm the causal association between the use of ACEIs and lung cancer risk.
血管紧张素转换酶抑制剂（ACEI）的使用与肺癌风险之间的关联仍存在争议。本研究评估了 ACEI 的使用与肺癌风险之间的关联。
从五个数据库中检索了从建立到 2022 年 1 月 26 日的记录。记录了年龄≥18 岁、至少随访一年且报告不良事件（包括肺癌）的临床研究，并为 ACEI 和对照组分别提供了单独的结果报告。由三位作者独立提取数据，并使用随机效应模型进行汇总。主要结局是肺癌的发生。计算了比值比（ORs）及其 95%置信区间（CIs）和肺癌相关发病率。
在筛选出的 2400 条记录中，从 7 项队列研究和 4 项病例对照研究中纳入了 13061226 名患者。汇总结果显示，ACEI 使用与肺癌风险增加相关（OR 1.19，95%CI 1.05-1.36；P=0.008），存在高度异质性（I=98%）。
ACEI 的使用是肺癌发生的一个比血管紧张素受体阻滞剂更大的风险因素，尤其是在亚洲患者中。需要进一步的随机对照试验来确认 ACEI 使用与肺癌风险之间的因果关系。
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