Nonsteroidal anti-inflammatory drugs and the esophageal inflammation-metaplasia-adenocarcinoma sequence
Nonsteroidal anti-inflammatory drugs and the esophageal inflammation-metaplasia-adenocarcinoma sequence
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DOI：
10.1158/0008-5472.can-05-4253
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发表时间：
2006-05-01
期刊：
影响因子：
11.2
通讯作者：
Murray, Liam J.
中科院分区：
文献类型：
--
作者：
Anderson, Lesley A.;Johnston, Brian T.;Murray, Liam J.
观察性研究表明，非甾体类抗炎药（NSAID）可降低食管腺癌的风险，但尚不清楚它们可能在食管炎症-化生-腺癌序列的哪个阶段起作用。在一项全爱尔兰病例对照研究中，我们调查了使用NSAID与反流性食管炎、Barrett食管和食管腺癌风险之间的关系。从整个爱尔兰招募食管腺癌、长段Barrett食管患者和人群对照。仅从北方爱尔兰招募食管炎患者。在访谈前至少一年，收集食管腺癌已知和潜在危险因素以及NSAID（包括阿司匹林）使用情况的数据。非甾体抗炎药的使用和食管炎症-化生-腺癌序列的阶段之间的关联通过多元逻辑回归进行估计。总共招募了230例反流性食管炎、224例Barrett食管、227例食管腺癌和260例对照人群。阿司匹林和非甾体抗炎药的使用与巴雷特食管风险降低相关[比值比[OR; 95%置信区间（95% CI）]，0.53食管腺癌[OR（95%CI）分别为0.57（0.36-0.93）和0.58（0.31-1.08）]。Barrett食管和食管腺癌患者使用NSAID的可能性低于对照组。选择或回忆偏倚可以解释这些结果和先前观察性研究的结果，这些研究表明NSAID对食管腺癌具有保护作用。如果非甾体抗炎药对食管炎症-化生-腺癌序列具有真正的保护作用，那么它们可能会在序列的早期发挥作用。
Observational studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of esophageal adenocarcinoma, but it is not known at what stage they may act in the esophageal inflammation-metaplasia-adenocarcinoma sequence. In an all-Ireland case-control study, we investigated the relationship between the use of NSAIDs and risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. Patients with esophageal adenocarcinoma, long-segment Barrett's esophagus and population controls were recruited from throughout Ireland. Esophagitis patients were recruited from Northern Ireland only. Data were collected on known and potential risk factors for esophageal adenocarcinoma and on the use of NSAIDs, including aspirin, at least I year before interview. Associations between use of NSAIDs and the stages of the esophageal inflammation-metaplasia-adenocarcinoma sequence were estimated by multiple logistic regression. In total, 230 reflux esophagitis, 224 Barrett's esophagus, and 227 esophageal adenocarcinoma and 260 population controls were recruited. Use of aspirin and NSAIDs was associated with a reduced risk of Barrett's esophagus [odds ratio [OR; 95% confidence interval (95% CI)], 0.53 (0.31-0.90) and 0.40 (0.19-0.81), respectively] and esophageal adenocarcinoma [OR (95% CI), 0.57 (0.36-0.93) and 0.58 (0.31-1.08), respectively]. Barrett's esophagus and esophageal adenocarcinoma patients were less likely than controls to have used NSAIDs. Selection or recall bias may explain these results and the results of previous observational studies indicating a protective effect of NSAIDs against esophageal adenocarcinoma. If NSAIDs have a true protective effect on the esophageal inflammation-metaplasia-adenocarcinoma sequence, they may act early in the sequence.