Phosphodiesterase 5 Inhibitor Use and Risk of Conventional and Serrated Precursors of Colorectal Cancer.
Phosphodiesterase 5 Inhibitor Use and Risk of Conventional and Serrated Precursors of Colorectal Cancer.
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磷酸二酯酶5抑制剂的使用与常规和锯齿状结直肠癌前体的风险
DOI：
10.1158/1055-9965.epi-20-1126
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Giovannucci EL
中科院分区：
文献类型：
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作者：
Zhang Y;Lo CH;Giovannucci EL
磷酸二酯酶5（PDE 5）抑制剂已被假设在结直肠癌（CRC）中具有化学保护作用。然而，目前基于人群的流行病学证据是有限的和不一致的。在18，123名至少进行过一次下消化道内窥镜检查的健康专业人员随访研究中，我们评估了2000年至2010年期间使用PDE 5抑制剂与传统腺瘤和锯齿状病变风险之间的相关性，并对重复观察和多种风险因素进行了调整。我们按勃起功能障碍（艾德）分层，以解释潜在的“适应症混杂”。在随访期间，我们记录了2,595例常规腺瘤和1,395例锯齿状病变息肉。使用无艾德的人作为参考组，基线时最近使用PDE 5抑制剂与传统腺瘤风险降低无关（使用PDE 5抑制剂的艾德：比值比（OR）=1.08，95% CI=0.92 - 1.26;未使用PDE 5抑制剂的艾德：OR=0.95，95% CI=0.85 - 1.06），锯齿状病变（使用PDE 5抑制剂的艾德：OR=1.19，95% CI=0.97 - 1.45;未使用PDE 5抑制剂的艾德：OR=1.03，95% CI=0.89 - 1.19）或晚期传统腺瘤（使用PDE 5抑制剂的艾德：OR=1.20，95% CI=0.94至1.53;未使用PDE 5抑制剂的艾德：OR=0.95，95% CI=0.79至1.14）。以前也未发现与PDE 5抑制剂使用相关。我们没有发现PDE 5抑制剂的使用与CRC的常规和锯齿状前体风险之间存在关联的证据。我们发现，在一个10年随访的大规模男性人群中，PDE 5抑制剂的使用与CRC的前体不相关，这些前体经医学和生活方式风险因素调整。
Phosphodiesterase 5 (PDE5) inhibitors have been hypothesized to have chemoprotective effects in colorectal cancer (CRC). Current population-based epidemiologic evidence is, however, limited and inconsistent. Among 18,123 men in the Health Professionals Follow-up Study who had at least one lower gastrointestinal endoscopy, we evaluated the association between PDE5 inhibitors use and risk of conventional adenoma and serrated lesion between 2000 and 2010, adjusted for repeated observations and multiple risk factors. We stratified by erectile dysfunction (ED) to account for potential ‘confounding by indication’. We documented 2,595 conventional adenomas and 1,395 serrated lesion polyps during the follow-up period. Using people without ED as reference group, recent PDE5 inhibitors use at baseline was not associated with lower risk of conventional adenoma (ED with PDE5 inhibitors: odds ratio (OR)=1.08, 95% CI=0.92 to 1.26; ED without PDE5 inhibitors: OR=0.95, 95% CI=0.85 to 1.06), serrated lesions (ED with PDE5 inhibitors: OR=1.19, 95% CI=0.97 to 1.45; ED without PDE5 inhibitors: OR=1.03, 95% CI=0.89 to 1.19), or advanced conventional adenomas (ED with PDE5 inhibitors: OR=1.20, 95% CI=0.94 to 1.53; ED without PDE5 inhibitors: OR=0.95, 95% CI=0.79 to 1.14). No association was found for PDE5 inhibitors use ever before as well. We found no evidence of an association between PDE5 inhibitors use and risk of conventional and serrated precursors of CRC. We show that PDE5 inhibitors use is not associated with precursors of CRC adjusted for medical and lifestyle risk factors among a large population of men with ten years of follow-up.