Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK.
Br J Cancer. 2011 Jan 4;104(1):193-7. doi: 10.1038/sj.bjc.6605996. Epub 2010 Nov 16.
Several studies suggest links between cancer and tricyclic antidepressant use.
A case-control study using the General Practice Research Database examined whether previous tricyclic usage was associated with reduced incidence of brain (with glioma as a sub-category), breast, colorectal, lung and prostate cancers. Conditional logistic regression adjusted for age, gender, general practice, depression, smoking, body mass index, alcohol use and non-steroidal anti-inflammatory drug use.
A total of 31 953 cancers were identified, each matched with up to two controls. We found a statistically significant reduction in tricyclic prescriptions compared with controls in glioma (odds ratio (OR) =0.59, 95% confidence interval (CI)=0.42-0.81) and colorectal cancer patients (OR=0.84, CI=0.75-0.94). These effects were dose-dependent (P-values for trend, glioma=0.0005, colorectal=0.001) and time-dependant (P-values for trend glioma=0.0005, colorectal=0.0086). The effects were cancer-type specific, with lung, breast and prostate cancers largely unaffected by antidepressant use.
The biologically plausible, specific and dose- and time-dependant inverse association that we have found suggests that tricyclics may have potential for prevention of both colorectal cancer and glioma.
多项研究表明癌症与三环类抗抑郁药的使用之间存在关联。
一项使用全科医学研究数据库的病例对照研究，调查了先前使用三环类药物是否与脑癌（包括神经胶质瘤作为一个亚类）、乳腺癌、结直肠癌、肺癌和前列腺癌的发病率降低有关。条件逻辑回归调整了年龄、性别、全科医生、抑郁、吸烟、体重指数、饮酒和非甾体抗炎药的使用。
共发现 31953 例癌症，每例癌症与多达两名对照相匹配。我们发现与对照组相比，接受神经胶质瘤（比值比（OR）=0.59，95%置信区间（CI）=0.42-0.81）和结直肠癌患者（OR=0.84，CI=0.75-0.94）的三环类药物处方明显减少。这些效果与剂量有关（趋势检验的 P 值，神经胶质瘤=0.0005，结直肠癌=0.001）和时间相关（趋势检验的 P 值，神经胶质瘤=0.0005，结直肠癌=0.0086）。这些效果是癌症类型特异性的，与肺癌、乳腺癌和前列腺癌相比，抗抑郁药的使用对这些癌症的影响不大。
我们发现的具有生物学合理性、特异性、剂量和时间依赖性的相反关联表明，三环类药物可能具有预防结直肠癌和神经胶质瘤的潜力。
