Aspirin, NSAIDs, and risk of prostate cancer: results from the REDUCE study.
Aspirin, NSAIDs, and risk of prostate cancer: results from the REDUCE study.
复制标题
DOI：
10.1158/1078-0432.ccr-14-2235
复制
发表时间：
2015-02-15
期刊：
影响因子：
--
通讯作者：
Freedland SJ
中科院分区：
文献类型：
--
作者：
Vidal AC;Howard LE;Moreira DM;Castro-Santamaria R;Andriole GL;Freedland SJ
最近的一项荟萃分析显示，阿司匹林与降低前列腺癌 (PC) 风险相关。由于抗炎药物会降低 PSA 水平，因此这些发现是否反映了 PC 检测的减少或 PC 风险的降低尚不清楚。我们在 REDUCE 中测试了阿司匹林和非阿司匹林 NSAID 与 PC 诊断之间的关联，其中所有男性在 2 年和 4 年接受了活检，很大程度上与 PSA 无关。 REDUCE 测试了度他雄胺可降低 PSA 为 2.5-10.0 ng/mL 且研究前活检呈阴性的男性 PC 风险。我们在 6,390 名接受 ≥1 次研究活检的男性中使用多项 Logistic 回归分析了阿司匹林、NSAID 或两者与总、低级别（Gleason<7）或高级别（Gleason≥7）PC 与无 PC 之间的关联。多变量分析针对年龄、种族、地理区域、PSA、前列腺体积、直肠指检、BMI、治疗组、吸烟、酒精、他汀类药物、高血压、糖尿病和心血管疾病进行了调整。总体而言，3,169 名男性 (50%) 不使用阿司匹林，1,368 名男性 (21%) 使用阿司匹林，1,176 名男性 (18%) 使用非甾体抗炎药，677 名男性 (11%) 两者都使用。在未经调整的模型中，阿司匹林与降低 PC 风险相关（OR=0.85，p=0.036）。在多变量分析中，阿司匹林与总 PC 风险降低相关（OR=0.81，p=0.015）。使用 NSAID 或 NSAIDs 与阿司匹林与总 PC、低级别或高级别 PC 无关，但所有 OR 均 < 1（所有 p ≥ 0.08）。因此，我们创建了阿司匹林和/或非甾体抗炎药使用者与非使用者的二分变量。在多变量分析中，阿司匹林和/或 NSAID 的使用与总体风险（OR=0.87，p=0.030）和高级别风险（OR=0.80，p=0.040）的降低显着相关，但与低级别 PC 风险无关（OR=0.90，p=0.15）。安慰剂组和度他雄胺组的结果相似。在活检呈阴性的男性中，使用阿司匹林和/或 NSAID 与 PC 风险降低相关。需要进行额外的研究。
A recent meta-analysis showed aspirin was associated with reduced prostate cancer (PC) risk. As anti-inflammatory medications lower PSA levels, whether these findings reflect reduced PC detection or lower PC risk is unknown. We tested the association between aspirin and non-aspirin NSAID on PC diagnosis in REDUCE, where all men received biopsies at 2- and 4-years largely independent of PSA. REDUCE tested dutasteride for PC risk reduction in men with a PSA of 2.5-10.0 ng/mL and a negative pre-study biopsy. We examined the association between aspirin, NSAID or both and total, low-grade (Gleason<7), or high-grade (Gleason≥7) PC vs. no PC using multinomial logistic regression among 6,390 men who underwent ≥1 on-study biopsy. Multivariable analyses were adjusted for age, race, geographic region, PSA, prostate volume, digital rectal examination, BMI, treatment arm, smoking, alcohol, statins, hypertension, diabetes and cardiovascular disease. Overall, 3,169 men (50%) were non-users, 1,368 (21%) used aspirin, 1,176 (18%) used NSAID, and 677 (11%) used both. In unadjusted models, aspirin was associated with reduced PC risk (OR=0.85, p=0.036). In multivariable analyses, aspirin was associated with reduced total PC risk (OR=0.81, p=0.015). Use of NSAID or NSAIDs and aspirin was not associated with total, low- or high-grade PC, though all ORs were <1 (all p≥0.08). Therefore, we created a dichotomous variable of aspirin and/or NSAID user vs. not. On multivariable analysis, the use of aspirin and/or NSAID was significantly associated with decreased total (OR=0.87, p=0.030) and high-grade (OR=0.80, p=0.040), but not with low-grade PC risk (OR=0.90, p=0.15). Results were similar in placebo and dutasteride arms. Among men with a negative biopsy, aspirin and/or NSAID use was associated with decreased PC risk. Additional studies are warranted.