Statin use and risk of pancreatic cancer: results from a large, clinic-based case-control study.
Statin use and risk of pancreatic cancer: results from a large, clinic-based case-control study.
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DOI：
10.1002/cncr.29256
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发表时间：
2015-04-15
期刊：
影响因子：
6.2
通讯作者：
Bracci, Paige M.
中科院分区：
文献类型：
--
作者：
Walker, Evan J.;Ko, Andrew H.;Holly, Elizabeth A.;Bracci, Paige M.
关键词：
他汀类药物是一种降胆固醇药物，具有多种作用，包括改变生长信号，以及可能改变癌症风险的免疫调节和抗炎作用。关于他汀类药物的使用是否与降低胰腺癌(PC)风险有关，先前流行病学研究的证据并不一致。确诊为PC的患者(病例)从内科和外科肿瘤学诊所招募，对照组(按性别和年龄匹配的频率)从普通内科诊所招募，在六年期间(2006-2011年)在一个高容量的学术医疗中心招募。直接访谈是使用流行病学危险因素问卷进行的，调查主题包括病史、生活方式因素和用药情况。调整后的多变量Logistic回归用于计算优势比(OR)和95%可信区间(95%CI)，作为PC相对风险的估计。数据来自536例患者和869名对照。曾使用他汀类药物的患者发生PC的风险降低34%(OR=0.66，95%CI为0.47~0.92)。在性别分层分析中，只有男性的风险显著降低(男性：OR=0.50，95%可信区间0.32-0.79；女性：OR=0.86，95%可信区间0.52-1.43)。使用时间与患PC的风险呈负相关(使用10年：OR=0.51总体；在男性，OR=0.41，95%可信区间0.21-0.80；P趋势=0.006)。这是一项最大规模的病例对照研究，证明了他汀类药物的使用与PC风险之间存在负相关。他汀类药物使用者的风险降低似乎与性别有关，在长期服用他汀类药物的人中更为明显。有必要进行进一步的研究，以更好地描述这种联系，并阐明潜在的生物机制的作用。
Statins are cholesterol-lowering medications with pleiotropic effects including alterations in growth signaling as well as immunomodulatory and anti-inflammatory effects that may alter cancer risk. Evidence from previous epidemiologic studies is inconsistent regarding whether statin use is associated with reduced risk of pancreatic cancer (PC). Patients with confirmed diagnoses of PC (cases) were recruited from medical and surgical oncology clinics, with controls (frequency-matched by sex and age) recruited from general medicine clinics, at a high-volume academic medical center over a six-year period (2006–2011). Direct interviews were conducted using an epidemiological risk factor questionnaire covering topics such as medical history, lifestyle factors, and medication usage. Adjusted multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (95%CI) as estimates of the relative risk of PC. Data were obtained from 536 cases and 869 controls. Ever use of statins was associated with 34% reduced PC risk (OR=0.66, 95%CI 0.47–0.92). In sex-stratified analyses, risk was statistically significantly reduced in men only (men: OR=0.50, 95%CI 0.32–0.79; women: OR=0.86, 95%CI 0.52–1.43). Duration of use was inversely associated with PC risk (>10 year use: OR=0.51 overall; in men, OR=0.41, 95%CI 0.21–0.80; ptrend=0.006). This is the largest case-control study to demonstrate an inverse association between statin use and PC risk. Risk reduction in statin users appears to be sex-specific and is more pronounced in long-term users. Further research is warranted to better characterize this association and clarify roles of underlying biologic mechanisms.
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