| Objective:Hepatocellular carcinoma is one of the commonly occurring cancer in the world,especially patients with chronic liver diseases at high risk are more likely to develop into hepatocellular carcinoma.Previous studies have suggested that statins may be associated with reduced risk for hepatocellular carcinoma,This article uses meta-analysis to further explore the association between statin use and risk of hepatocellular carcinoma in patients of chronic liver diseases.Methods:A comprehensive literature search was conducted in Chinese and foreign databases such as PubMed?The Cochrane Library?Embase?Web of Science?VIP?Wan Fang and CNKI databases.The literatures associated between statin use and risk of liver cancer in patients with chronic liver diseases were collected through February 2020.Two researchers independently screened the literature according to the established inclusion and exclusion criteria,extracted data on the included studies,the Newcastle-Ottawa Scale(NOS)was used to score the quality of the included studies.Finally Rev Man 5.3 software was used for meta-analysis.The effect estimate was reported as pooled odds ratio(OR)with 95%confidence interval(CI).I~2 and?~2 tests were used to evaluate the heterogeneity between the results of the included studies,and a fixed-effects model or a random-effects model was selected for analysis based on the heterogeneity results.Results:Finally,12 articles were included in the meta-analysis,including 7 cohort studies and 5case-control studies.(1)Random-effect models was used for analysis,the analysis results showed that using statins can effectively reduce the the risk of hepatocellular carcinoma in patients of chronic liver diseases(OR=0.5,95%CI:0.43-0.58,P<0.00001).(2)The etiology subgroup analysis results showed that statins can decrease the incidence of liver cancer in patients with chronic hepatitis B(OR=0.56,95%CI:0.47-0.66,P<0.00001)and chronic hepatitis C(OR=0.56,95%CI:0.45-0.71,P<0.00001);Subgroup analysis by statin type showed that lipophilic statins can reduce the risk of liver cancer in patients of chronic liver diseases(OR=0.48,95%CI:0.39-0.59,P<0.00001),but hydrophilic statins had no significant difference in the risk of hepatocellular carcinoma in patients of chronic liver diseases.(OR=0.64,95%CI:0.36-1.14,P=0.13).Conclusion:Statins can significantly reduce the the risk of hepatocellular carcinoma in patients of chronic liver diseases,including chronic hepatitis B and chronic hepatitis C populations.Among them,lipophilic statins have a significant preventive effect on the progression of chronic liver disease to liver cancer,but the effect of hydrophilic statins is not obvious. |
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