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AJG:阿司匹林和选择性 5-羟色胺再摄取抑制剂的联合使用可以降低结直肠癌风险

2021-06-26 MedSci原创 MedSci原创

结直肠癌 (CRC) 仍然是全世界第三大最常见的癌症,在2018年,结肠癌是全球癌症相关死亡的第二大原因,约占癌症病例和死亡人数的十分之一。

      结直肠癌 (CRC) 仍然是全世界第三大最常见的癌症,在2018年,结肠癌是全球癌症相关死亡的第二大原因,约占癌症病例和死亡人数的十分之一。近年来,全球 CRC的发病率一直在增长,从2007年的130万增加到 2017年的180万,增长了38%。因此,有效的预防策略对于降低CRC的发病率至关重要。化学预防,即使用药物阻断疾病的发病途径,已成为预防癌症的一种很有效的方法。近几十年来,大量基础、临床和流行病学证据表明,低剂量阿司匹林(乙酰水杨酸)对癌症,尤其是结直肠癌具有一致的化学预防作用。阿司匹林通过多种机制发挥其抗癌作用,其中联合抗血小板和抗炎作用可以预防 CRC 中炎症相关的肿瘤发生。

 

     另一种药物-选择性5-羟色胺再摄取抑制剂(SSRIs)是抑郁症患者的一线药物。SSRIs 对 CRC 也具有潜在的抗炎和抗血小板作用。一项探索性分析发现,与 SSRI 使用相关的 CRC 风险降低可能仅限于非甾体抗炎药或阿司匹林使用者,因此表明 SSRI 和阿司匹林的共同给药可能产生协同作用。本项研究旨在探究阿司匹林和选择性 5-羟色胺再摄取抑制剂 (SSRIs) 的使用——无论是作为单一疗法还是联合用药——是否可以对 CRC 产生临床益处。

 

      研究人员使用瑞典全国登记册进行了病例对照研究,总共招募了 24786 例 CRC 病例,并使用发病密度抽样随机匹配 74358 名对照患者。条件逻辑回归模型用于计算优势比 (OR) 和 95% 置信区间 (CI)。结果显示阿司匹林和 SSRIs 单药治疗均与 CRC 风险呈负相关,但阿司匹林和 SSRIs 联合使用与阿司匹林单药治疗(调整后 OR,0.91)相比,CRC 风险更低(调整后 OR,0.77,95% CI,0.67-0.89)。而CRC 与阿司匹林和 SSRIs 的负相关显示出剂量依赖性模式。

 

      这项研究表明,阿司匹林和 SSRIs 的使用——无论是作为单一疗法还是联合用药——都与降低 CRC 的风险相关。阿司匹林和 SSRIs 联合使用有更强的化学预防效果。

 

 

原始出处:

Zhang, Naiqi. Et al. Combined Use of Aspirin and Selective Serotonin Reuptake Inhibitors Is Associated With Lower Risk of Colorectal Cancer: A Nested Case-Control Study. The American Journal of Gastroenterology.2021.

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    2021-08-04 sjq027
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    2021-07-20 minzju5052
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