他汀类药物对肿瘤防治作用的临床证据评价

Clinical evidence assessment of statins for the prevention and treatment of cancer

目的:评价他汀类药物对肺癌、结直肠癌、乳腺癌、前列腺癌、胃癌、肝癌的防治作用。方法:计算机检索Cochrane library、Pubmed、中国期刊全文数据库(CNKI)、万方数据库,纳入他汀类药物关于肺癌、结直肠癌、乳腺癌、前列腺癌、胃癌、肝癌的系统评价或Meta分析,并按照牛津证据分级与推荐意见强度标准进行证据分级。结果:共检索得到18篇符合标准的文献,其中包含各种肿瘤类型的研究4篇、肺癌的研究1篇、结直肠癌的研究1篇、乳腺癌的研究2篇、前列腺癌的研究5篇、胃癌的研究3篇、肝癌的研究2篇,证据评价结果有9条Ⅰa级证据、1条Ⅰb级证据。结论:根据现有证据,他汀类药物不影响肺癌和乳腺癌的发生率,对降低前列腺癌的发生风险可能有一定效果,对胃癌、肝癌、结直肠癌的防治作用尚缺乏强有力地证据支持,期望将来高质量的随机对照试验为揭示他汀类药物与肿瘤的关系提供重要信息。

OBJECTIVE To evaluate the preventive effect and treatment of statins in lung cancer, colorectal cancer, breast cancer, prostatic cancer, gastric cancer and hepatic cancer. METHODS Four databases： Cochrane library, Pubmed, CNKI and WanFang, were retrieved by computer. The Meta^analysis and systematic review about cancers of the lung, colorectal , breast, prostate, stomach and liver were included. The quality assessment was performed according to the standard of Oxford Centre for Evidence-based Medicine-Levels of Evidence Grades of Recommendation. RESULTS A total of eighteen studies were included and the cancer types of these studies concentrated were as follows： four papers for all-cancers, one paper for lung cancer, one paper for colorectal cancer, two papers for breast cancer, five papers for prostatic cancer, three papers for gastric cancer, two papers for hepatic cancer. There were nine studies and one study separately evaluated as I a grade and I b grade. CONCLUSION Based on current evidence, statins are not associated with lung cancer and breast cancer risk, while statins may have some positive effects on preventing prostatic cancer. Strong evidence is still lacking for gastric cancer, hepatic cancer and colorectal cancer with statins usage in prevention and treatment. Significant information from high quality studies of randomized control trials is expected to reveal the relationship between statins and cancer.