Use of cyclooxygenase inhibitors and risk of melanoma in high-risk patients
Use of cyclooxygenase inhibitors and risk of melanoma in high-risk patients
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DOI：
10.1097/00042728-200507000-00003
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发表时间：
2005-07-01
影响因子：
2.4
通讯作者：
Kirsner, RS
中科院分区：
文献类型：
--
作者：
Ramirez, CC;Ma, FC;Kirsner, RS
背景资料。体外和动物研究的结果表明，环氧合酶(COX)抑制剂可以降低黑色素瘤的风险，但在人类中，证据仍然有限。目的：在一项初步的回顾性队列研究中，确定COX抑制剂的使用与高危患者黑色素瘤的发生率、复发和转移的关系。方法：研究方法。回顾迈阿密退伍军人事务医疗中心的计算机记录，我们回顾了高危受试者中COX抑制剂的使用与黑色素瘤发病率、复发和转移之间的关系：白人受试者曾被诊断为黑色素瘤(1996-2003)。我们评估了三种可能的结果：新的黑色素瘤诊断、既往黑色素瘤复发和黑色素瘤转移。研究对象包括83名黑色素瘤患者。28例服用COX抑制剂的受试者中有1例发生转移，而55例未服用COX抑制剂的患者中有4例新发黑色素瘤(7.3%)，2例黑色素瘤复发，6例转移(10.9%)。虽然没有单独的结果指标达到统计学意义，但结合这三项指标，服用COX抑制剂的患者显著低于未服用COX抑制剂的患者(1比12；p=0.05)。在调整了年龄和肿瘤侵袭深度后，使用COX抑制剂的患者黑色素瘤预后指标的发生率显著降低(优势比0.08，95%可信区间0.01-0.77；P.03)。结论：高危患者存在化学预防黑色素瘤的潜力。
BACKGROUND. Results from in vitro and animal studies suggest that cyclooxygenase (COX) inhibitors may reduce the risk of Melanoma, but among humans, the evidence remains limited.OBJECTIVE. In a pilot retrospective cohort, to determine the relationship between the use of COX inhibitors and the incidence, recurrence, and metastases of melanoma in high-risk patients. METHODS. Reviewing computerized records at the Miami Veterans Affairs Medical Center, we retrospectively examined the association between COX inhibitor use and melanoma incidence, recurrence, and metastases in high-risk subjects: white subjects previously diagnosed with melanoma (1996-2003). We evaluated three potential outcomes: new melanoma diagnosis, recurrcncc of a previous melanoma, and melanoma metastasis.Results. Eighty-three subjects with melanoma were included. There was one metastasis among 28 subjects prescribed COX inhibitors, whereas four new melanomas (7.3%), two melanoma recurrences, and six metastases (10.9%) occurred among 55 patients not prescribed COX inhibitors. Although no individual outcomes measures reached statistical significance, combining the three measures., these were significantly lower in users of COX inhibitors compared with nonusers (1 vs 12; p =.05). After adjustment for age and tumor depth of invasion, COX inhibitor users had significantly lower rates of melanoma outcome measures (odds ratio 0.08, 95% confidence interval 0.01-0.77; p.03).CONCLUSION. Potential exists for chemoprevention of melanoma among high-risk patients.