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阿片类药物或是导致胰腺癌发病率升高的潜在原因

2021-01-07 MedSci原创 MedSci原创

胰腺癌是当前恶性程度最高的肿瘤之一,被称为“癌症之王”。胰腺癌起病比较隐匿,80%以上的患者在确诊时已经是中晚期,五年生存率很低,到目前为止尚无治愈该病的方法。

胰腺癌是当前恶性程度最高的肿瘤之一,被称为“癌症之王”。胰腺癌起病比较隐匿,80%以上的患者在确诊时已经是中晚期,五年生存率很低,到目前为止尚无治愈的方法。虽然胰腺癌的既定危险因素包括遗传易感综合征和慢性胰腺炎,但多数病例病因仍不明确。

近日,发表于PLOS ONE杂志的一项研究显示,阿片类药物的使用可能是导致胰腺癌发病率上升的一个未被发现的风险因素。在癌症人群中,疼痛是一种非常普遍的现象,而阿片类药物是治疗中度或重度慢性癌症疼痛的一线方法。然而,阿片类药物滥用和服用过量已演变成公共卫生危机。据数据显示,2017年报告了约70000例药物过量死亡,有68%涉及阿片类药物的使用。

在这项研究中,研究人员调取了来自疾病控制和预防中心(CDC)的美国癌症统计数据库,探索分析了1999年-2016年间胰腺癌发病率变化与阿片类药物使用之间可能的联系。为了校正其他胰腺癌的危险因素,研究人员还分析了当前的吸烟率(1999年至2017年)、肥胖率(1999年至2018年)和饮酒率(1999年至2018年)与4年之后的胰腺癌发生发展的潜在关系。

结果显示,在1999年-2016年,美国新发700300例胰腺癌,因使用阿片类药物而死亡的有351630例。胰腺癌发病率和阿片类药物死亡率在各州之间的分布存在明显差异。然而,大多数州胰腺癌的发病率和死亡率都有所上升,且胰腺癌的平均发病率以每年0.137个百分点的速度递增。

1999年和2016年,胰腺癌发病率及各州阿片类药物死亡率数据

通过延迟4年的危险因素来解释癌前病变的发展

为了了解使用阿片类药物死亡率的变化和胰腺癌发病率变化之间的关联,研究人员考察了不同州阿片类药物死亡率与胰腺癌发生率之间的关联。结果发现,胰腺癌和阿片类药物的死亡率均随时间的推移而增加。先前的阿片类药物死亡率可预测了数年后胰腺癌发生趋势。同时,研究人员进一步观察到,在研究期间,阿片类药物死亡率显著增加,肥胖症患病率也在增加。然而,酒精的流行率没有增加或减少,香烟的流行率在随时间的推移显著下降。

发病率和风险因素随年份变化情况

总之,阿片类药物的使用与胰腺癌的风险之间存在一定的联系。未来,需要直接基于大型或纵向数据开展阿片类药物的使用与胰腺癌发病率之间相关性的研究,一旦获得有关阿片类药物使用和胰腺癌风险的个体数据,可能为胰腺癌患者的疼痛治疗提供新的方法。

原始出处
Usman Barlass et al. Opioid use as a potential risk factor for pancreatic cancer in the United States: An analysis of state and national level databases, PLOS ONE (2021). 

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    2021-05-13 ms6000001624652641

    那胰腺癌还能用**?

    0

  4. 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    2021-01-12 ms6000000156981277

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  6. 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likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83976, encryptionId=04b5839e6a9, topicName=胰腺癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Thu Jan 07 20:57:33 CST 2021, time=2021-01-07, status=1, ipAttribution=)]
    2021-01-09 lhlxtx
  8. 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likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83976, encryptionId=04b5839e6a9, topicName=胰腺癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Thu Jan 07 20:57:33 CST 2021, time=2021-01-07, status=1, ipAttribution=)]
    2021-01-07 rayms

    emmm...zhe....

    0

  9. 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    2021-01-07 飞翔的乌龟

    0

  10. 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createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Thu Jan 07 22:42:45 CST 2021, time=2021-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914513, encodeId=e67291451330, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201110/2d55d24dc5fd419d994b7b920c79731b/d3c8bdca983c4af1b90220a8192e353a.jpg, createdBy=e14e5296465, createdName=飞翔的乌龟, createdTime=Thu Jan 07 21:36:02 CST 2021, time=2021-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914494, encodeId=1c6b914494fe, content=止疼药也不能盲目吃啊 <a href='/topic/show?id=04b5839e6a9' target=_blank style='color:#2F92EE;'>#胰腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83976, encryptionId=04b5839e6a9, topicName=胰腺癌)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Thu Jan 07 20:57:33 CST 2021, time=2021-01-07, status=1, ipAttribution=)]
    2021-01-07 Jessica

    止疼药也不能盲目吃啊 #胰腺癌#

    0

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