Chemoprevention of Oesophageal Squamous-Cell Carcinoma and Adenocarcinoma: A Multicentre Retrospective Cohort Study
Chemoprevention of Oesophageal Squamous-Cell Carcinoma and Adenocarcinoma: A Multicentre Retrospective Cohort Study
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DOI：
10.1159/000520924
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发表时间：
2021-12-20
期刊：
影响因子：
3.2
通讯作者：
Koike, Kazuhiko
中科院分区：
文献类型：
--
作者：
Arai, Junya;Niikura, Ryota;Koike, Kazuhiko
背景：食管癌包括两种不同的组织学变异：食管鳞状细胞癌（ESCC）和腺癌（EAC）。虽然这两种类型都有多种治疗选择，但晚期或转移性食管癌患者的预后仍然很差。目的：本研究旨在研究食管癌风险与药物之间的关系，并估计常用药物的化学预防作用。方法：采用9家医院数据库2014 - 2019年住院患者数据进行多中心回顾性队列研究。主要结局为ESCC和EAC。评价食管癌与药物使用及临床因素的关系。比值比（ORs）根据年龄、性别、Charlson合并症指数评分和有无胃食管反流病的吸烟情况进行调整。结果：质子泵抑制剂（PPIs）（调整后的OR [aOR] 0.48, p < 0.0001）、阿司匹林（aOR 0.32, p < 0.0001）、环氧化酶-2抑制剂（COX2I） （aOR 0.70, p = 0.0005）、类固醇（aOR 0.19, p < 0.0001）、他汀类药物（aOR 0.43, p < 0.0001）和二甲双胍（aOR 0.42, p < 0.0001）的使用与ESCC的风险较不使用相关。使用阿司匹林（aOR 0.33, p = 0.0006）和类固醇（aOR 0.54, p = 0.022）与EAC风险较低相关。结论：COX2Is、他汀类药物、二甲双胍和PPIs对ESCC有预防作用，阿司匹林和类固醇对两种食管癌均有化学预防作用。
Background: Oesophageal cancer comprises 2 different histological variants: oesophageal squamous-cell carcinoma (ESCC) and adenocarcinoma (EAC). While there are multiple therapeutic options for both types, patients with advanced or metastatic oesophageal cancer still suffer from poor prognosis. Aims: The study aimed to examine the association between the risk of oesophageal cancer and medications and to estimate the chemopreventive effects of commonly used drugs. Methods: A multicentre retrospective cohort study was conducted using data from 9 hospital databases of hospitalized patients between 2014 and 2019. The primary outcomes were ESCC and EAC. The association of oesophageal cancer with drug use and clinical factors was evaluated. Odds ratios (ORs) were adjusted for age, sex, Charlson comorbidity index scores, and smoking with/without gastro-oesophageal reflux disease. Results: The use of proton pump inhibitors (PPIs) (adjusted OR [aOR] 0.48, p < 0.0001), aspirin (aOR 0.32, p < 0.0001), cyclooxygenase-2 inhibitor (COX2I) (aOR 0.70, p = 0.0005), steroid (aOR 0.19, p < 0.0001), statin (aOR 0.43, p < 0.0001), and metformin (aOR 0.42, p < 0.0001) was associated with a lower risk of ESCC than that in non-use. The use of aspirin (aOR 0.33, p = 0.0006) and steroids (aOR 0.54, p = 0.022) was associated with a lower risk of EAC than that in non-use. Conclusion: COX2Is, statins, metformin, and PPIs could help in prevention of ESCC, and aspirin and steroids may be chemopreventive for both types of oesophageal cancer.