阿司匹林治疗乳腺癌效果的Meta分析

Meta-analysis of aspirin in treating breast cancer

目的评价阿司匹林是否可以改善乳腺癌治疗效果。方法在PubMed、Web of science、Cochrane Library、万方及中国期刊全文数据库中搜索近年来有关阿司匹林治疗乳腺癌的相关临床随机对照文献,进行逐篇质量评价并提取资料,采用Review Manager 5.3软件进行数据的统计学分析。结果共纳入9个随机对照研究,合计162 381例患者入组,其中服用阿司匹林组(观察组)乳腺癌患者59 934例,未服用阿司匹林组(对照组)为102 447例乳腺癌患者。Meta分析结果显示,阿司匹林有助于降低乳腺癌死亡风险[RR=0.83,95%CI(0.73,0.94),Z=2.89,P=0.004],乳腺癌诊断前服用和诊断后服用阿司匹林效果Meta分析结果显示,合并效应量[RR=0.60,95%CI(0.32,1.14),Z=1.57,P=0.12]。两组患者中月经状态、体质指数(BMI)、淋巴结转移、人表皮生长因子受体2(Her2)表达、性激素受体(HR)表达水平、是否接受内分泌治疗及化疗之间合并效应量分析结果提示差异无统计学意义(P>0.05),肿瘤大小两组之间合并效应量分析结果提示差异有统计学意义(P<0.05)。结论服用阿司匹林可能对乳腺癌治疗有一定的积极作用,有助于改善患者的预后,但需要进一步排除肿瘤大小对试验结果的影响。

Objective To evaluate the effect of aspirin in treating breast cancer.Methods Randomized controlled trials of aspirin for treatment of breast cancer were searched in the databases of PubMed, Web of science, Cochrane Library, WanFang and CNKI in recent years, evaluate quality of each article and extract the data, the outcome indexes were analyzed by RevMan 5.3.Results 9 randomized clinical trials including 162 381 patients were selected, there were 59 934 breast cancer patients in the aspirin group(observation group) and 102 447 breast cancer patients in the non-aspirin group(control group).Meta-analysis showed that the aspirin use daily compared with non-use associated with a decreased risk of breast cancer death[RR=0.83,95%CI(0.73,0.94),Z=2.89,P=0.004], analysis of the effects of aspirin taken before and after diagnosis of breast cancer showed combined effect size was not statistically significant[RR=0.60, 95%CI(0.32, 1.14), Z=1.57,P=0.12].Further analysis of menstrual cycle, body mass index(BMI),lymph node metastasis, human epidermal growth factor receptor 2(Her2),hormone receptors(HR),endocrine therapy and chemotherapy effect between two groups indicates no statistical difference(P>0.05), tumor volume consolidation effect quantity analysis results suggest differences between two groups have statistical significance(P<0.05).Conclusion Taking aspirin may have certain positive effect on breast cancer treatment and help to improve the prognosis of patients, however, the effect of tumor size on the result needs to be further confirmed.