Aspirin use after a prostate cancer diagnosis and cancer survival in a prospective cohort.
Aspirin use after a prostate cancer diagnosis and cancer survival in a prospective cohort.
复制标题
DOI：
10.1158/1940-6207.capr-12-0171
复制
发表时间：
2012-10
期刊：
影响因子：
--
通讯作者：
Chan JM
中科院分区：
文献类型：
--
作者：
Dhillon PK;Kenfield SA;Stampfer MJ;Giovannucci EL;Chan JM
实验和临床数据表明，阿司匹林和其他非类固醇炎症药物可能通过抑制环氧合酶(COX)途径及其对细胞增殖、凋亡和血管生成的影响来延缓前列腺癌的进展。流行病学数据支持使用阿司匹林可降低前列腺癌发病率，但尚无证据表明确诊后服用阿司匹林是否会影响病情进展或生存。我们对1990年1月1日至2005年12月31日期间被诊断患有前列腺癌的3986名健康专业人员后续研究的参与者进行了前瞻性研究。我们使用COX比例风险回归来评估诊断后使用阿司匹林与2008年1月31日发生转移或致命前列腺癌之间的关系，调整了与该队列中的发病率和死亡率相关的危险因素、诊断前使用阿司匹林、Gleason评分、TNM分期和主要治疗。在18年的随访中，总共有265名男性发生了骨转移或其他器官转移或致命的前列腺癌。我们没有观察到在确诊后更新使用阿司匹林与致死性前列腺癌之间的关系(每周服用2片阿司匹林，HR=1.12，95%CI：0.72，1.72；2-5，HR=1.05，95%CI：0.62，1.80，≥6，HR=1.08，95%CI：0.76，1.54；p趋势=0.99)。当我们只检查基线(p趋势=0.70)或使用频率(天数/周，p趋势=0.35)的阿司匹林使用时，结果保持不变；或者将结果限制为致命的前列腺癌(p趋势=0.63)。在这群前列腺癌幸存者中，前列腺癌确诊后服用阿司匹林与致命疾病之间没有关联。
Experimental and clinical data suggest that aspirin and other non-steroidal inflammatory drugs may delay the progression of prostate cancer through inhibition of the cyclooxygenase (COX) pathway and its effects on cellular proliferation, apoptosis and angiogenesis. Epidemiological data support a reduced risk of prostate cancer incidence with aspirin use, yet no evidence exists regarding whether aspirin after diagnosis influences progression or survival. We conducted a prospective study of 3,986 participants of the Health Professionals Follow-up Study, with a prostate cancer diagnosis between January 1, 1990 and December 31, 2005. We used Cox proportional hazards regression to evaluate the association between aspirin use after diagnosis and the development of metastases or fatal prostate cancer through January 31, 2008, adjusting for risk factors associated with incidence and mortality in this cohort, pre-diagnostic aspirin use, Gleason score, TNM stage and primary treatment. In total, 265 men developed bony or other organ metastases or fatal prostate cancer during the 18 years of follow-up. We observed no association between updated aspirin use after diagnosis and lethal prostate cancer (tablets/week: <2, HR=1.12, 95% CI: 0.72, 1.72; 2-5, HR=1.05, 95% CI: 0.62, 1.80, ≥ 6, HR=1.08, 95% CI: 0.76, 1.54; p-trend=0.99). The results remained unchanged when we examined aspirin use at baseline only (p-trend=0.70) or frequency of use (days/week, p-trend=0.35); or limited the outcome to fatal prostate cancer (p-trend = 0.63). There was no association between aspirin use after a prostate cancer diagnosis and lethal disease in this cohort of prostate cancer survivors.