他汀类药物的使用与胰腺癌发生风险的荟萃分析

doi:10.5246/jcps.2019.12.081

中国药学(英文版) ›› 2019, Vol. 28 ›› Issue (12): 855-867.DOI: 10.5246/jcps.2019.12.081

他汀类药物的使用与胰腺癌发生风险的荟萃分析

宋瑶^1,2, 支小飞³, 赵洪瑜², 周兴芹², 陈文娟², 向田直史⁴, 林清^1*, 季斌^2*

1. 同济大学附属第十人民医院放疗科, 上海 200072
2. 南通大学附属医院肿瘤放疗科, 江苏南通 226001
3. 南通大学附属医院普外科, 江苏南通 226001
4. 金泽大学癌症研究所分子应答免疫实验室, 日本石川金泽 920-0921

收稿日期:2019-08-28 修回日期:2019-10-13 出版日期:2019-12-28 发布日期:2019-11-06
通讯作者: Tel.: +86-513-81161256; +86-513-66301078, E-mail: jbnantong@163.com; linqing.linda@163.com
基金资助:
Doctoral Fund of Ministry of Education of Jiangsu Province (Grant No. 2018K256C).

Meta-analysis of the effect of statin use and pancreatic cancer risk

Yao Song^1,2, Xiaofei Zhi³, Hongyu Zhao², Xingqin Zhou², Wenjuan Chen², Naofumi Mukaida⁴, Qing Lin^1*, Bin Ji^2*

1. Department of Radiation oncology, Tenth People’s Hospital Affliated to Tongji University, Shanghai 200072, China
2. Department of Radiation oncology, Affiliated Hospital of Nantong University, Nantong Jiangsu Province, China
3. Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
4. Naofumi Mukaida, Division of Molecular Bioregulation, Cancer Research Institute, Kanazawa University, Kanazawa, Ishikawa 920-0921, Japan

Received:2019-08-28 Revised:2019-10-13 Online:2019-12-28 Published:2019-11-06
Contact: Tel.: +86-513-81161256; +86-513-66301078, E-mail: jbnantong@163.com; linqing.linda@163.com
Supported by:
Doctoral Fund of Ministry of Education of Jiangsu Province (Grant No. 2018K256C).

摘要/Abstract

摘要：

他汀类药物被认为可以降低胰腺癌发生的风险, 但并非所有结果均一致, 为了更清楚地了解他汀类药物的使用与胰腺癌发生风险的关系, 本研究通过meta分析了解他汀类药物在胰腺癌发生风险中的作用。主要通过pubmed、embase和cochrane图书馆数据库使用以下搜索词: (1)他汀类(“他汀类”, “3-羟基-3-甲基戊二酰辅酶-A还原酶抑制剂”, “阿托伐他汀”, “辛伐他汀”, “氟伐他汀”, “洛伐他汀”, “普伐他汀”, “瑞舒伐他汀”, “辛伐他汀”); (2)胰腺癌(“癌”、“肿瘤”、“恶性”)进行检索, 发现从2001年至2018年7月, 共发表21项研究, 涉及1 148 680例病例和2 177 842名对照, 符合筛选标准。并应用STATA 14.0软件对所有数据进行分析。结果显示, 他汀类药物的使用与胰腺癌发生风险显著相关(OR = 0.84, 95% CI 0.72–0.98,P = 0.000, I² = 84.3%), 其中脂溶性他汀类药物(OR = 1.07, 95% CI 0.97–1.18, P = 0.651, I² = 0.0%)对胰腺癌的风险没有显著影响。相反, 短期(OR = 0.72, 95% CI 0.54–0.96, P = 0.000, I² = 80.1%)和长期(OR = 0.70, 95% CI 0.54–0.92, P = 0.000, I² = 79.8%)使用他汀类药物可显著降低胰腺癌发生风险。亚组分析发现当排除三项针对限制种群的研究, 可以消除所选研究之间的高度异质性。

关键词: 胰腺癌, 荟萃分析, 他汀类药物, 风险, 结果

Abstract:

Statin has been proposed to have a capacity to reduce the risk of pancreatic cancer, while the obtained results are notconsistent. To gain a clearer picture of the relationship between statin use and pancreatic cancer, the present meta-analysis took into consideration data from eight cohort studies, ten case-control studies and three RCTs.We searched all relevant studies on the effect of statin use on the risk of pancreatic cancer using PubMed, Embase and the Cochrane library database from inception to July 30, 2018. The following search terms were used: (1) statin (“statins”, “statin”, “3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors”, “atorvastatin”, “cerivastatin”, “fluvastatin”, “lovastatin”, “pravastatin”, “rosuvastatin”, “simvastatin”); (2) pancreatic cancer (“cancer”, “neoplasm”, “malignancy”). We manually examined the references of the relevant articles and reviews to identify additional studies. A total of 21studies, published between 2001 and July 2018 and involving 1 148 680 cases and 2 177 842 controls, fulfilled the selection criteria. The pooled results revealed a significant relationship between statin use andpancreatic cancer risk (OR = 0.84, 95% CI 0.72–0.98, P = 0.000, I²= 84.3%). However, lipophilic statins (OR = 1.07, 95% CI 0.97–1.18,P = 0.651, I²= 0.0%) had no significant effect on the risk of pancreatic cancer. In contrast, short-term statin use (OR = 0.72, 95% CI 0.54–0.96, P = 0.000, I²= 80.1%) and long-term statin use (OR = 0.70, 95% CI 0.54–0.92, P = 0.000, I²= 79.8%)significantly reduced pancreatic cancer risk. Notably, the high heterogeneity among the selected studies was eliminated by excluding the three studies that focused on restricted populations. Statin could significantly reduce the risk of pancreatic cancer.

Key words: Pancreatic cancer, Meta-analysis, Statin, Risk, Outcome

中图分类号:

R969

Supporting:

宋瑶, 支小飞, 赵洪瑜, 周兴芹, 陈文娟, 向田直史, 林清, 季斌. 他汀类药物的使用与胰腺癌发生风险的荟萃分析[J]. 中国药学(英文版), 2019, 28(12): 855-867.

Yao Song, Xiaofei Zhi, Hongyu Zhao, Xingqin Zhou, Wenjuan Chen, Naofumi Mukaida, Qing Lin, Bin Ji. Meta-analysis of the effect of statin use and pancreatic cancer risk[J]. Journal of Chinese Pharmaceutical Sciences, 2019, 28(12): 855-867.

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他汀类药物的使用与胰腺癌发生风险的荟萃分析

Meta-analysis of the effect of statin use and pancreatic cancer risk

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