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GUT:口服抗生素与结直肠肿瘤风险差异

2019-08-21 MedSci MedSci原创

研究发现口服抗生素会增加结肠癌风险,但降低了直肠癌风险,这种效应的异质性可能提示肠道微生物区系和下肠道癌变机制的差异

微生物群失调易导致直肠癌(CRC),近日研究人员评估口服抗生素使用与CRC风险的关系。

研究人员考察1989至2012年间相关资料,采用临床实践研究数据进行了一项匹配的病例对照研究。

总计28980例CRC病例和137 077例对照。口服抗生素直肠癌风险增加相关,但其影响因解剖位置而异。抗生素的使用以剂量依赖性的方式增加结肠癌风险。即使在最少使用剂量后也可以观察,在近端结肠和使用具有抗厌氧活性的抗生素时风险最大。相反,抗生素使用与直肠癌呈负相关,特别是抗生素暴露时间>60天(调整OR值为0.85)人群。青霉素,特别是氨苄西林/阿莫西林增加了结肠癌的风险(aOR =1.09),而四环素则降低了直肠癌的风险(aOR =0.90)。在诊断前10年(aOR =1.17)即可发现抗生素与癌症的关联。

研究发现口服抗生素会增加结肠癌风险,但降低了直肠癌风险,这种效应的异质性可能提示肠道微生物区系和下肠道癌变机制的差异。

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