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Clin Gastroenterol H:平时服用他汀 凶残的胰腺癌来临时能有一线生机?

2018-09-04 贾朝娟 环球医学

胰腺癌被称为“癌中之王”,并不是浪得虚名,死亡率高达99%。美国作家埃德加·斯诺、《人鬼情未了》的男主角帕特里克、歌王帕瓦罗蒂、原国务院副总理黄菊、九段棋手陈祖德等,这些大家所熟知的大人物,尽管声名显赫,也拥有优越的医疗条件,最后也都还是没能从胰腺癌的魔爪下觅得生机。

胰腺癌被称为“癌中之王”,并不是浪得虚名,死亡率高达99%。美国作家埃德加·斯诺、《人鬼情未了》的男主角帕特里克、歌王帕瓦罗蒂、原国务院副总理黄菊、九段棋手陈祖德等,这些大家所熟知的大人物,尽管声名显赫,也拥有优越的医疗条件,最后也都还是没能从胰腺癌的魔爪下觅得生机。

即使近年来新的治疗方案不断涌现,大多数晚期胰腺癌患者仍难以活过1年。丞待“神药”出现来拯救这些中了胰腺癌魔咒的患者。

他汀类药物,常用于降低血脂水平和预防血管疾病,近年来发现其可能还与癌症患者生存时间延长相关。然而,他汀是否能改善胰腺癌患者结局,尚是未知。

2018年8月,发表在《Clin Gastroenterol Hepatol》的一项研究,分析了胰腺癌诊断前使用他汀与生存时间的相关性。

研究对象由648名护士健康研究和卫生专业人员随访研究中的受试者组成,这些参与者于2000~2013年确诊为胰腺癌。

研究者使用调整了潜在混杂因素的Cox比例风险回归模型,评估总体死亡率的风险比(HR)。考虑到他汀使用与癌症生存期之间可能存在潜伏期,评估诊断前使用他汀和癌症生存期之间的时间相关性时,使用了2年的滞后期。

结果显示,与不常规使用他汀相比,胰腺癌诊断前常规使用他汀与生存期中度延长相关,可延长其中位生存期1个月。

癌症确诊前2年内常规使用他汀,与较长生存期的相关性最强烈。

吸烟状态、体重指数、糖尿病或癌症分期,对相关性无显著影响。

在护士健康研究和卫生专业人员随访研究中,诊断前常规使用他汀与生存期之间的相关性相似。

作者认为,2项大型前瞻性队列研究显示,胰腺癌确诊前常规使用他汀与生存时间的中度延长相关。

总之,在该2个随访10年以上的大型美国队列研究中,在胰腺癌诊断前规律使用他汀类药物,与患者生存率改善有关。

鉴于他汀类药物总体严重不良反应发生率较低,而且可能具有抗肿瘤生物学机制,应进一步研究他汀类药物用于胰腺癌的作用。

梅斯医学小编:
这篇研究很有意思,值得我们思考。他汀抗肿瘤作用机制到底是什么?是抑制了炎症,还是抑制了肿瘤的侵袭或转移?小编联想到此前一篇研究:Nat Commun:科学家发现乳腺癌扩散的罪魁祸首“高胆固醇”,确定新的药物靶点 ,高胆固醇可能是癌症转移的重要因素之一,这与他汀有关?不管怎么说,他汀,阿司匹林一类抗肿瘤的作用,都值得探索。

原始出处:

Hamada T, Khalaf N, Yuan C, et.al. Prediagnosis Use of Statins Associates With Increased Survival Times of Patients With Pancreatic Cancer. Clin Gastroenterol Hepatol. 2018 Aug;16(8):1300-1306.e3. doi: 10.1016/j.cgh.2018.02.022. Epub 2018 Feb 21.

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    2018-10-13 许安
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    2018-09-09 小丫剪剪

    厉害了,还可以通过胆固醇转移。但是,很奇怪的是,癌细胞怎么和胆固醇分离并到达靶向部位呢,如果胆固醇在肝脏代谢后是否能被消灭还是重生

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2072279, encodeId=396d20e2279c8, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sat Oct 13 17:04:00 CST 2018, time=2018-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711629, encodeId=25291e11629d5, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Aug 01 00:04:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064473, encodeId=ceaf20644e385, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Dec 02 08:04:00 CST 2018, time=2018-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344078, encodeId=b1733440e817, content=厉害了,还可以通过胆固醇转移。但是,很奇怪的是,癌细胞怎么和胆固醇分离并到达靶向部位呢,如果胆固醇在肝脏代谢后是否能被消灭还是重生, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL17rDiannrcyanJmkf7FuVvyvSJVq3X3CJicNKByjQTYDpvh8GHSHcNBhl6TuDB0ZSN291fySWbDuQ/132, createdBy=b7432293626, createdName=小丫剪剪, createdTime=Sun Sep 09 01:00:12 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343359, encodeId=f1e13433594e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Fri Sep 07 07:26:22 CST 2018, time=2018-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342788, encodeId=6765342e88d8, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 22:22:39 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342778, encodeId=61f1342e78b0, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 22:05:28 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342670, encodeId=a9ae3426e0a4, content=好文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 20:57:10 CST 2018, time=2018-09-04, status=1, ipAttribution=)]
    2018-09-07 phoebeyan520

    学习了

    0

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    2018-09-04 青龙偃月

    好文章学习了!

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2072279, encodeId=396d20e2279c8, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sat Oct 13 17:04:00 CST 2018, time=2018-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711629, encodeId=25291e11629d5, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Aug 01 00:04:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064473, encodeId=ceaf20644e385, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Dec 02 08:04:00 CST 2018, time=2018-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344078, encodeId=b1733440e817, content=厉害了,还可以通过胆固醇转移。但是,很奇怪的是,癌细胞怎么和胆固醇分离并到达靶向部位呢,如果胆固醇在肝脏代谢后是否能被消灭还是重生, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL17rDiannrcyanJmkf7FuVvyvSJVq3X3CJicNKByjQTYDpvh8GHSHcNBhl6TuDB0ZSN291fySWbDuQ/132, createdBy=b7432293626, createdName=小丫剪剪, createdTime=Sun Sep 09 01:00:12 CST 2018, time=2018-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343359, encodeId=f1e13433594e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Fri Sep 07 07:26:22 CST 2018, time=2018-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342788, encodeId=6765342e88d8, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 22:22:39 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342778, encodeId=61f1342e78b0, content=好文章学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 22:05:28 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342670, encodeId=a9ae3426e0a4, content=好文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160905/IMG57CD39B82D12E7926.jpg, createdBy=ac2c1946830, createdName=青龙偃月, createdTime=Tue Sep 04 20:57:10 CST 2018, time=2018-09-04, status=1, ipAttribution=)]
    2018-09-04 青龙偃月

    好文章学习了!

    0

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    2018-09-04 青龙偃月

    好文章,学习了!

    0

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