Shaheen Nicholas J, Straus Walter L, Sandler Robert S
Division of Digestive Diseases and Nutrition and the Center For Gastrointestinal Biology and Disease, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7080, USA.
Cancer. 2002 Feb 15;94(4):950-63.
In multiple studies, the chronic use of nonsteroidal antiinflammatory drugs (NSAIDs) has been associated with a decreased incidence of several types of gastrointestinal (GI) neoplasia. This effect may be mediated by one of several intracellular mechanisms, some of which involve the inhibition of the cyclooxygenase-2 (COX-2) isoenzyme. In multiple studies of colorectal carcinoma, chronic NSAID use has shown a protective effect, with the majority of studies demonstrating a 30-70% risk reduction associated with NSAID use. The effect of NSAIDs on other types of GI neoplasia is less clear, but evidence suggests that chronic NSAID use may diminish the risk of esophageal and gastric carcinomas. Data assessing the effects of NSAIDs on the incidence of pancreatic and hepatic malignancies currently are too sparse and inconsistent to draw any conclusions. The newer COX-2 specific agents may provide a less GI-toxic alternative to nonselective NSAIDs as chemoprotective agents.
在多项研究中，长期使用非甾体抗炎药（NSAIDs）与几种胃肠道（GI）肿瘤的发病率降低有关。这种效应可能由几种细胞内机制之一介导，其中一些机制涉及对环氧合酶-2（COX-2）同工酶的抑制。在多项关于结直肠癌的研究中，长期使用NSAIDs已显示出保护作用，大多数研究表明与使用NSAIDs相关的风险降低了30%-70%。NSAIDs对其他类型GI肿瘤的影响尚不清楚，但有证据表明长期使用NSAIDs可能会降低食管癌和胃癌的风险。目前评估NSAIDs对胰腺癌和肝癌发病率影响的数据过于稀少且不一致，无法得出任何结论。新型COX-2特异性药物作为化学预防剂，可能为非选择性NSAIDs提供一种胃肠道毒性较小的替代选择。
