Aspirin and nonsteroidal anti-inflammatory agents and risk for colorectal adenomas
Aspirin and nonsteroidal anti-inflammatory agents and risk for colorectal adenomas
复制标题
DOI：
10.1016/s0016-5085(98)70526-8
复制
发表时间：
1998-03-01
期刊：
影响因子：
29.4
通讯作者：
Woosley, JT
中科院分区：
文献类型：
--
作者：
Sandler, RS;Galanko, JC;Woosley, JT
背景与目的：阿司匹林和非甾体类抗肿瘤药物已被报道可预防结直肠癌的发生。由于腺瘤是大多数结直肠癌的前体，本研究的目的是在基于结肠镜检查的病例对照研究中检查这些药物与结直肠腺瘤风险的关系。方法：研究参与者来自北卡罗来纳州大学医院接受结肠镜检查的患者。通过电话使用处方药和非处方药的综合清单以及可能与腺瘤发展相关的饮食和生活方式因素的问题来评估药物使用情况。结果：210例腺瘤患者和169例无腺瘤对照。在调整潜在的混杂因素后，与非使用者相比，经常使用者目前患有腺瘤的可能性是一半（调整后的比值比，0.56; 95%置信区间，0.34-0.92）。在结肠镜检查前至少1年停止用药的常规使用者仍然受到保护（调整后的比值比，0.59; 95%置信区间，0.21-1.67），尽管少数人使这一结论是暂时的。阿司匹林和非阿司匹林类非甾体抗炎药的保护作用相似。结论：结果提示阿司匹林和非甾体类抗炎药可导致腺瘤-癌序列的早期破坏。未来的挑战将是更多地了解剂量，持续时间和作用机制。
Background & Aims: Aspirin and nonsteroidal antiinflammatory drugs have been reported to protect against the development of colorectal cancer. Because adenomas are precursors to most colorectal cancers, the aim of this study was to examine the relationship of these medications to the risk for colorectal adenomas in a colonoscopy-based case-control study. Methods: Study participants were drawn from patients who underwent colonoscopy at the University of North Carolina Hospitals. Medication use was assessed by telephone using a comprehensive list of prescription and nonprescription drugs as well as questions about dietary and lifestyle factors that might be relevant for adenoma development. Results: There were 210 patients with adenomas and 169 adenoma-free controls. After adjusting for potential confounders, regular users were half as likely to currently have adenomas compared with nonusers (adjusted odds ratio, 0.56; 95% confidence interval, 0.34-0.92). Regular users who stopped medication at least 1 year before colonoscopy were still protected (adjusted odds ratio, 0.59; 95% confidence interval, 0.21-1.67), although small numbers make this conclusion tentative. The protective effects of aspirin and the nonaspirin nonsteroidal anti-inflammatory drugs were similar. Conclusions: The results suggest that aspirin and nonsteroidal anti-inflammatory drugs cause early disruption of the adenoma-carcinoma sequence. The challenge for the future will be to learn more about dose, duration, and mechanism of action.