Ramirez Claudia C, Ma Fangchao, Federman Daniel G, Kirsner Robert S
Department of Dermatology and Cutaneous Surgery, University of Miami, Florida, USA.
Dermatol Surg. 2005 Jul;31(7 Pt 1):748-52. doi: 10.1097/00042728-200507000-00003.
Results from in vitro and animal studies suggest that cyclooxygenase (COX) inhibitors may reduce the risk of melanoma, but among humans, the evidence remains limited.
In a pilot retrospective cohort, to determine the relationship between the use of COX inhibitors and the incidence, recurrence, and metastases of melanoma in high-risk patients.
Reviewing computerized records at the Miami Veterans Affairs Medical Center, we retrospectively examined the association between COX inhibitor use and melanoma incidence, recurrence, and metastases in high-risk subjects: white subjects previously diagnosed with melanoma (1996-2003). We evaluated three potential outcomes: new melanoma diagnosis, recurrence of a previous melanoma, and melanoma metastasis.
Eighty-three subjects with melanoma were included. There was one metastasis among 28 subjects prescribed COX inhibitors, whereas four new melanomas (7.3%), two melanoma recurrences, and six metastases (10.9%) occurred among 55 patients not prescribed COX inhibitors. Although no individual outcomes measures reached statistical significance, combining the three measures, these were significantly lower in users of COX inhibitors compared with nonusers (1 vs 12; p = .05). After adjustment for age and tumor depth of invasion, COX inhibitor users had significantly lower rates of melanoma outcome measures (odds ratio 0.08; 95% confidence interval 0.01-0.77; p = .03).
Potential exists for chemoprevention of melanoma among high-risk patients.
体外和动物研究结果表明，环氧化酶（COX）抑制剂可能降低黑色素瘤风险，但在人类中，证据仍然有限。
在一项前瞻性回顾性队列研究中，确定高危患者使用COX抑制剂与黑色素瘤的发病率、复发率和转移率之间的关系。
通过查阅迈阿密退伍军人事务医疗中心的计算机记录，我们回顾性研究了高危受试者（1996 - 2003年期间先前被诊断为黑色素瘤的白人受试者）使用COX抑制剂与黑色素瘤发病率、复发率和转移率之间的关联。我们评估了三个潜在结果：新发黑色素瘤诊断、既往黑色素瘤复发和黑色素瘤转移。
纳入了83例黑色素瘤患者。在28例使用COX抑制剂的患者中有1例发生转移，而在55例未使用COX抑制剂的患者中有4例新发黑色素瘤（7.3%）、2例黑色素瘤复发和6例转移（10.9%）。尽管单个结果指标均未达到统计学显著性，但将这三个指标综合起来，COX抑制剂使用者的这些指标显著低于未使用者（1例对12例；p = 0.05）。在对年龄和肿瘤浸润深度进行调整后，COX抑制剂使用者的黑色素瘤结果指标发生率显著较低（优势比0.08；95%置信区间0.01 - 0.77；p = 0.03）。
高危患者中存在黑色素瘤化学预防的潜力。
