他汀类药物的使用似乎可以降低肝癌患者的死亡风险，在一组肝癌患者（HCC）中，局部和全身治疗或手术切除并额外使用他汀类药物的死亡率要比那些不使用他汀类药物的患者降低了30%（HR 0.7，95%CI:0.5～0.9），根据休斯敦德克萨斯大学安德森癌症中心的医学博士 Young Kwang Chae和他的同事报告。
在调整年龄，性别，种族，分期，丙型肝炎和乙型肝炎史，肝硬化，治疗方式，使用酒精以及糖尿病后，总生存期（OS）仍然有着显着的积极影响（aHR 0.7，95%CI 0.5～0.9，P=0.03）。Chae在2013年胃肠道癌症研讨会的壁报中指出。
作者指出，“临床证据支持他汀类药物的抗肿瘤活性，”他补充称，肝细胞癌是一种血管疾病，一些观察性研究显示，他汀类药物的使用能降低肝细胞癌的发病率。
研究人员随访了644例经病理证实的HCC患者达10年以上。样本包括68名他汀类药物使用者和571名非他汀使用者，大多是白人（分别为69.1%和65%），男性（分别为77.9%和72.9%）。所有患者的中位OS为19.2个月，10.7%是他汀类药物的使用者。
超过一半（70.7%）经诊断，TNM分期为Ⅲ期和Ⅳ期，52.6%的人没有B型或C型肝炎病毒感染的证据，81.7%的患者进行了局部治疗和全身治疗，而18.3%经历手术切除。
他汀类药物使用者的中位OS为高于非他汀类药物使用者（25.4 VS 18.5 个月，P=0.04）。在无肝硬化的患者中，他汀类药物的使用降低了40%死亡率（HR 0.6，95%CI：0.4～0.9，P=0.04）。
肝炎病史不影响结果，年龄，性别，种族，分期，治疗类型，酒精的使用，或糖尿病状态对结果也没有影响。
Chae指出，肝癌患者服用他汀类药物的都是老年人（平均年龄63.1岁），并且许多有糖尿病（51.5%）。这些参与者有更多的心血管疾病，更容易生病，预后差，但是，事实上，他们却活得更长。
编译自：Statins May Lower Death Risk in Liver Ca，medpagetoday，January 27, 2013
论文摘要：
The association between statin use and hepatocellular cancer outcome.
The association between statin use and hepatocellular cancer outcome.
Background: Preclinical evidence supports anti-tumoral activity of statins. Several observational studies have shown inverse association between statin use and hepatocellular cancer (HCC) incidence. However, little is known as to whether statins can delay the progression of HCC. Therefore, we investigated the association between statin use and the outcome of patients with HCC.
Methods: 644 patients diagnosed with pathologically confirmed HCC were followed up from 2000 till 2011. Survival analysis was done using Cox regression model.
Results: The mean age of the HCC cohort was 63.1 years (SD, ±11.5). 73.4% were men and 65.5% were Caucasians. 70.7% were diagnosed at TNM stage III and IV. 52.6% had no evidence of hepatitis B or C virus infection. 81.7% had local and systemic therapy, while 18.3% underwent surgical resection. The median survival of HCC patients was 19.2 months. 10.7% of patients reported statin use. We observed significant difference in overall survival between statin non-users and users; the median overall survival (95% CI) were 18.5 (16.4-20.5) months and 25.4 (19.8-31.1) months, respectively (log rank test p = 0.04). 30% mortality reduction was observed in statin users versus non-users (HR = 0.7, 95% CI, 0.5-0.9). This significant association was also observed in patients who received systemic and local therapy (p = 0.04). HCC patient without liver cirrhosis showed 40% mortality reduction (HR = 0.6, 95% CI, 0.4-0.9, P = 0.04) while patient with liver cirrhosis did not. History of hepatitis did not affect the association. Even after controlling for various clinical variables including age, sex, race, staging, HCV, HBV, liver cirrhosis, treatment, alcohol use and diabetes, statin use was still associated with favorable overall survival in HCC patients (HR = 0.7, 95% CI, 0.5-0.9, P=0.03).
Conclusions: This is the largest study to date to evaluate the effect of statins on the outcomes of HCC patients. We found that statin use may reduce the risk of death in patients with HCC. Validation of our finding is warranted in a large prospective study.
Methods: 644 patients diagnosed with pathologically confirmed HCC were followed up from 2000 till 2011. Survival analysis was done using Cox regression model.
Results: The mean age of the HCC cohort was 63.1 years (SD, ±11.5). 73.4% were men and 65.5% were Caucasians. 70.7% were diagnosed at TNM stage III and IV. 52.6% had no evidence of hepatitis B or C virus infection. 81.7% had local and systemic therapy, while 18.3% underwent surgical resection. The median survival of HCC patients was 19.2 months. 10.7% of patients reported statin use. We observed significant difference in overall survival between statin non-users and users; the median overall survival (95% CI) were 18.5 (16.4-20.5) months and 25.4 (19.8-31.1) months, respectively (log rank test p = 0.04). 30% mortality reduction was observed in statin users versus non-users (HR = 0.7, 95% CI, 0.5-0.9). This significant association was also observed in patients who received systemic and local therapy (p = 0.04). HCC patient without liver cirrhosis showed 40% mortality reduction (HR = 0.6, 95% CI, 0.4-0.9, P = 0.04) while patient with liver cirrhosis did not. History of hepatitis did not affect the association. Even after controlling for various clinical variables including age, sex, race, staging, HCV, HBV, liver cirrhosis, treatment, alcohol use and diabetes, statin use was still associated with favorable overall survival in HCC patients (HR = 0.7, 95% CI, 0.5-0.9, P=0.03).
Conclusions: This is the largest study to date to evaluate the effect of statins on the outcomes of HCC patients. We found that statin use may reduce the risk of death in patients with HCC. Validation of our finding is warranted in a large prospective study.
