服用阿司匹林对结直肠癌患者生存获益的Meta分析与系统评价

Aspirin Improves Survival of Colorectal Cancer Patients:A Meta-analysis and Systematic Evaluation

目的采用Meta分析探讨服用阿司匹林是否改善结直肠癌患者的预后。方法检索Pub Med、EMBASE数据库中关于服用阿司匹林与结直肠癌预后关系的文献,提取整体生存以及肿瘤特异性生存的预后相关结果进行效应量的合并,对纳入的数据进行亚组分析、发表偏倚分析等。所有统计分析均采用Review Manager 5.2软件完成。结果共纳入13篇文献,共计结直肠癌患者43 173例。Meta分析结果显示,服用阿司匹林的结直肠癌患者较未服用患者生存获益,并且在诊断后服用阿司匹林的结直肠癌患者整体生存和肿瘤特异性生存均较好,但是在诊断前服用阿司匹林的结直肠癌患者并没有显著的生存获益。结论诊断后服用阿司匹林可改善结直肠癌患者的预后生存。

Objective To systematically assess the relationship between oral administration of aspirin and survival benefit for patients with colorectal cancer（CRC）by meta-analysis. Methods Relevant studies were identified through searching Pub Med and EMBASE. Random-effects model was derived to composite the pooled hazard ratio for overall mortality and CRC-specific mortality. The subgroup analysis was conducted for included data,and the bias analysis was reported. Results Thirteen studies on aspirin therapy were finally included in this meta-analysis. The overall survival benefit associated with oral administration of aspirin represented an HR of 0.83（95% CI：0.71-0.96）. Oral administration of aspirin was also associated with CRC-specific survival（HR=0.77,95% CI：0.64-0.93）. No evidence was observed of an association between prediagnostic aspirin use and CRC overall survival（HR=1.00,95% CI：0.85-1.18）or CRC-specific survival（HR=0.97,95% CI：0.83-1.13）. Conclusion These findings provide further indication that post-diagnostic aspirin therapy can improve CRC prognosis.