他汀类药物对胃癌预防效果的系统评价

摘要

目的：综合评价他汀类药物对胃癌的预防效果。方法系统检索 PubMed （1966.01—2014.05）、EMBase （1998.01—2014.05）及Web of Science （1993.01—2014.05）中关于他汀类药物对胃癌预防效果的文献。采用RevMan 5.2软件对符合纳入及排除标准的文献进行Meta分析。结果共纳入文献11篇，总样本量为5459975例，胃癌患者数为5581例，他汀类药物使用者数为962192例。 Meta分析结果：（1）8项观察性研究的Meta分析显示，他汀组患者的胃癌发病率与非他汀组比较，差异有统计学意义〔OR （95％CI）＝0.76（0.71，0.81）， P＜0.01〕。6项高质量观察性研究的Meta分析显示，他汀组患者的胃癌发病率与非他汀组比较，差异有统计学意义〔OR （95％CI）＝0.88（0.82，0.95）， P＜0.01〕。（2）3项随机对照试验的Meta分析显示，他汀组患者的胃癌发病率与非他汀组比较，差异无统计学意义〔OR （95％CI）＝0.85（0.67，1.07）， P＝0.17〕。（3）将观察性研究和随机对照试验合并后，11项研究的Meta分析显示，他汀组患者的胃癌发病率与非他汀组比较，差异有统计学意义〔OR （95％CI ）＝0.77（0.72，0.82）， P＜0.01〕。结论他汀类药物对胃癌有一定的预防作用，但效果并不明确，需严格且高质量的大规模随机对照试验进一步证实。%Objective To make a comprehensive evaluation of statins on the prevention of gastric cancer .Methods We made a systematic retrieval in PubMed ( 1966.01—2014.05 ) , EMBase ( 1998.01—2014.05 ) and Web of Science (1993.01—2014.05) to collect literatures about the efficacy of statins on the prevention of gastric cancer .Using RevMan 5.2 software, meta-analyses were made on the literatures that accorded with the inclusion and exclusion criteria .Results We included 11 pieces of literatures concerning with all together 5 459 975 subjects, among which 5 581 subjects were patients with gastric cancer and 962 192 subjects were users of statins .The results of the meta -analyses were as follows . ( 1 ) The meta-analysis on 8 observational studies showed that statins group and non statins group were significantly different in the incidence of gastric cancer 〔OR (95%CI) =0.76 (0.71, 0.81), P <0.01〕 .The meta -analysis of 6 high -quality observational studies showed that statin group and non statin group were significantly different in the incidence of gastric cancer 〔OR (95%CI)=0.88 (0.82, 0.95), P<0.01〕 .(2) The meta-analysis of three random control trials showed that statins group and non statins group were not significantly different in the incidence of gastric cancer 〔OR (95%CI) =0.85 (0.67, 1.07), P=0.17〕 .(3) The meta-analysis of 11 studies including both observational studies and random control trials , statins group and non statins group were significantly different in the incidence of gastric cancer 〔OR (95%CI) =0.77 (0.72, 0.82), P<0.01〕 .Gonclusion Statins is effective in the prevention of gastric cancer to some extent , while the exact effect is not clear , which needs further verification by rigorous , high-quality and large-scale random control trials .