Clouser Mary C, Roe Denise J, Foote Janet A, Harris Robin B
Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85719, USA.
Pharmacoepidemiol Drug Saf. 2009 Apr;18(4):276-83. doi: 10.1002/pds.1718.
Recent studies link the prostaglandin metabolic pathway to skin carcinogenesis expanding possibilities that cyclooxygenase (COX) inhibitors may be utilized in non-melanoma skin cancer (NMSC) chemoprevention. Using data from a study of the efficacy of retinol supplementation on incidence of NMSC, we sought to determine the role of non-steroidal anti-inflammatory drugs (NSAIDs) in NMSC development. Cox proportional hazards models describe the relationship between NSAID use and time to first squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) among participants categorized by use pattern: continuous users (use for length of study duration), new users (use for less than study duration), and non-users. For SCC and BCC, there was a statistically significant protective effect for participants who reported use for less than the study duration (HR = 0.49, 95%CI 0.28-0.87 and HR = 0.43, 95%CI 0.25-0.73, respectively). Categorical examination of NSAIDs (aspirin (ASA) vs. non-ASA NSAIDs) showed significant effects for BCC among those using non-ASA NSAIDs for less than the study duration (HR = 0.33, 95%CI 0.13-0.80). For SCC and BCC, NSAID use of shorter duration and potentially more recent, was more protective than longer duration of use. These results are counter to the idea that longer duration of NSAID use is more protective. Additional investigations are needed into the role NSAIDs play in the chemoprevention of NMSC.
近期研究将前列腺素代谢途径与皮肤癌发生联系起来，这拓展了环氧化酶（COX）抑制剂可用于非黑色素瘤皮肤癌（NMSC）化学预防的可能性。利用一项关于补充视黄醇对NMSC发病率影响的研究数据，我们试图确定非甾体抗炎药（NSAIDs）在NMSC发生中的作用。Cox比例风险模型描述了按使用模式分类的参与者中NSAIDs使用与首次发生鳞状细胞癌（SCC）或基底细胞癌（BCC）时间之间的关系：持续使用者（在研究期间持续使用）、新使用者（使用时间少于研究期间）和非使用者。对于SCC和BCC，报告使用时间少于研究期间的参与者有统计学显著保护作用（HR = 0.49，95%CI 0.28 - 0.87和HR = 0.43，95%CI 0.25 - 0.73）。对NSAIDs（阿司匹林（ASA）与非ASA NSAIDs）的分类检查显示，使用非ASA NSAIDs时间少于研究期间的参与者中，对BCC有显著影响（HR = 0.33，95%CI 0.13 - 0.80）。对于SCC和BCC，使用时间较短且可能较近期的NSAIDs比使用时间较长更具保护作用。这些结果与NSAIDs使用时间越长保护作用越强的观点相反。需要对NSAIDs在NMSC化学预防中的作用进行更多研究。
