Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment.
Can Aspirin Use Be Associated With the Risk or Prognosis of Bladder Cancer? A Case-Control Study and Meta-analytic Assessment.
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阿司匹林的使用与膀胱癌的风险或预后有关吗？
DOI：
10.3389/fonc.2021.633462
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发表时间：
2021
影响因子：
4.7
通讯作者：
Li X
中科院分区：
文献类型：
--
作者：
Fan B;Mohammed A;Huang Y;Luo H;Zhang H;Tao S;Xu W;Liu Q;He T;Jin H;Sun M;Sun M;Yun Z;Zhao R;Wu G;Li X
阿司匹林，广泛用于预防心血管疾病，已与膀胱癌（BCa）的发病率。现有的针对中国人群的研究相对较少，尤其是针对中国东北地区。同时，阿司匹林对BCa发生或预后影响的相关研究不一致，甚至存在争议。首先，在病例对照研究中，使用logistic回归分析来研究阿司匹林摄入量与BCa风险之间的关系，包括1121例BCa患者和2242例对照。应用Kaplan-Meier曲线和考克斯回归分析，探讨阿司匹林摄入量与BCa患者临床病理因素的关系，以预测患者的总生存期（OS）和无复发生存期（RFS）。最后，我们将本研究结果与截至2021年5月1日发表的评价阿司匹林摄入量及其对BCa发生率、手术结局和预后影响的文献进行了Meta分析。我们的病例对照研究表明，定期使用阿司匹林与BCa发生率降低无关（P = 0.175）。性别分层分析显示，女性患者服用阿司匹林不会降低BCa的风险（P = 0.063）。而经常服用阿司匹林的男性人群BCa的发生率较低（OR = 0.748，95% CI = 0.584-0.958，P = 0.021）。按吸烟分层的亚组分析发现，目前吸烟者服用阿司匹林的BCa风险显著降低（OR = 0.522，95%CI = 0.342 - 0.797，P = 0.002）。在BCa的预后方面，Kaplan-Meier曲线显示，有阿司匹林摄入史的患者的OS或RFS并不明显长于无阿司匹林摄入史的患者。按性别分层分析显示，无论男性还是女性患者，阿司匹林摄入量与BCa复发或生存率之间均无相关性。然而，在68岁以下的人群中，阿司匹林摄入似乎对总生存期有延长作用（HR = 3.876; 95%CI = 1.326 - 11.325，P = 0.019）。然后，我们进行了荟萃分析，19篇文章的综合结果和我们的研究涉及超过39524例BCa病例，表明阿司匹林摄入与BCa的发生无关（P = 0.671）。按是否定期使用阿司匹林、使用阿司匹林的平均持续时间、性别、吸烟暴露、研究地区和研究类型进行的亚组分析也支持上述结果。在阿司匹林摄入对BCa患者预后的影响方面，11篇文章和我们的研究涉及8825例BCa病例。综合结果显示，与未服用阿司匹林的患者相比，服用阿司匹林对患者的生存、复发、进展和转移没有显著影响。总体而言，我们的回顾性研究和文献荟萃分析均表明阿司匹林的使用与BCa的发病率或预后之间缺乏强相关性。因此，需要进行额外的长期随访前瞻性研究，以阐明阿司匹林与BCa发病率和预后的关系。
Aspirin, widely used to prevent cardiovascular disease, had been linked to the incidence of bladder cancer (BCa). Existing studies focusing on Chinese populations are relatively rare, especially for Northeast China. Meanwhile, relevant studies on the effects of aspirin on the occurrence or prognosis of BCa are inconsistent or even controversial. First, in the case control study, logistic regression analysis was used to investigate the association between aspirin intake and risk of BCa including 1121 patients with BCa and the 2242 controls. Subsequently, Kaplan-Meier curve and Cox regression analyses were applied to explore the association between aspirin intake and clinicopathological factors which may predict overall survival (OS) and recurrence-free survival (RFS) of BCa patients. Finally, we quantificationally combined the results with those from the published literature evaluating aspirin intake and its effects on the occurrence, outcome of surgery and prognosis of BCa by meta-analysis up to May 1, 2021.Our case-control study demonstrated that the regular use of aspirin was not associated with a reduced incidence of BCa (P=0.175). Stratified analyses of sex showed that aspirin intake did not lead to a lower risk of BCa in female patients (P=0.063). However, the male population who regularly took aspirin had a lower incidence of BCa (OR=0.748, 95% CI= 0.584-0.958, P=0.021). Subgroup analyses stratified by smoking found a significant reduction in the risk of BCa in current smokers with aspirin intake (OR=0.522, 95% CI=0.342-0.797, P=0.002). In terms of prognosis of BCa, patients with a history of aspirin intake did not had a markedly longer OS or RFS than those with no history of aspirin intake by Kaplan-Meier curves. Stratified analysis by sex showed no correlation between aspirin intake and the recurrence or survival of BCa for either male or female patients. However, in people younger than 68, aspirin intake seemed to have prolonged effects for overall survival (HR=3.876; 95% CI=1.326-11.325, P=0.019). Then, we performed a meta-analysis and the combined results from 19 articles and our study involving more than 39524 BCa cases indicated that aspirin intake was not associated with the occurrence of BCa (P=0.671). Subgroup analysis by whether regular use of aspirin, by the mean duration of use of aspirin, by sex, by smoking exposure, by research region and by study type also supported the above results. In terms of the impact of aspirin intake on the prognosis of patients with BCa, 11 articles and our study involving 8825 BCa cases were eligible. The combined results showed that patients with aspirin intake did not have significantly influence on survival, recurrence, progression and metastasis than those without aspirin intake. On the whole, both our retrospective study and literature meta-analysis suggested a lack of a strong relevant association between the use of aspirin and the incidence or prognosis of BCa. Thus, additional long-term follow-up prospective research is warranted to clarify the association of aspirin with BCa incidence and prognosis.
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影响因子：
1.6
作者：
Hu J;Chen JB;Cui Y;Zhu YW;Ren WB;Zhou X;Liu LF;Chen HQ;Zu XB
通讯作者：
Zu XB
影响因子：
11.2
作者：
Henry WS;Laszewski T;Tsang T;Beca F;Beck AH;McAllister SS;Toker A
通讯作者：
Toker A
影响因子：
6.4
作者：
Brasky TM;Liu J;White E;Peters U;Potter JD;Walter RB;Baik CS;Lane DS;Manson JE;Vitolins MZ;Allison MA;Tang JY;Wactawski-Wende J
通讯作者：
Wactawski-Wende J
DOI：
10.3233/blc-160052
发表时间：
2016-04-27
期刊：
Bladder cancer (Amsterdam, Netherlands)
影响因子：
--
作者：
Godoy G;Gakis G;Smith CL;Fahmy O
通讯作者：
Fahmy O
影响因子：
5.6
作者：
Bilani N;Bahmad H;Abou-Kheir W
通讯作者：
Abou-Kheir W