Basler Joseph W, Piazza Gary A
University of Texas Health Sciences Center, San Antonio, 78229-3900, USA.
J Urol. 2004 Feb;171(2 Pt 2):S59-62; discussion S62-3. doi: 10.1097/01.ju.0000107839.06670.27.
There is increasing evidence that using nonsteroidal anti-inflammatory drugs decreases the incidence of clinically apparent prostate cancer. We review the potential mechanisms of cancer reduction with cyclooxygenase (COX)-2 inhibitors and the clinical evidence suggesting their effectiveness.
A literature review using MEDLINE was conducted of animal, observational, and clinical studies of nonsteroidal anti-inflammatory drugs in cancer, specifically prostate cancer. The Physician Data Query database was searched for current studies of COX-2 inhibitors for chemoprevention of prostate cancer.
Research suggests that COX-2 inhibiting medications are determinants in lower cancer incidence rates. Other studies have suggested up-regulation of the COX-2 enzyme in prostate cancer compared with normal prostate tissue. Selective COX-2 inhibitors are currently under study to evaluate their potential roles in preventing prostate cancer in high-risk patients (rofecoxib) or the recurrence of bladder cancer (celecoxib). Agents such as exisulind, which is a selective apoptotic antineoplastic drug, are also under investigation.
COX-2 inhibitors are promising agents for the chemoprevention of prostate cancer but further research is needed.
越来越多的证据表明，使用非甾体抗炎药可降低临床明显前列腺癌的发病率。我们综述了环氧化酶（COX）-2抑制剂降低癌症发病率的潜在机制以及表明其有效性的临床证据。
使用医学文献数据库（MEDLINE）对非甾体抗炎药在癌症，特别是前列腺癌方面的动物、观察性和临床研究进行了文献综述。在医师数据查询数据库中搜索了关于COX-2抑制剂用于前列腺癌化学预防的当前研究。
研究表明，COX-2抑制药物是癌症发病率降低的决定因素。其他研究表明，与正常前列腺组织相比，前列腺癌中COX-2酶上调。目前正在研究选择性COX-2抑制剂，以评估其在高危患者中预防前列腺癌（罗非昔布）或膀胱癌复发（塞来昔布）的潜在作用。像依西美坦这样的药物，它是一种选择性凋亡抗肿瘤药物，也在研究中。
COX-2抑制剂是前列腺癌化学预防的有前景的药物，但还需要进一步研究。
