Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
Cancer Prev Res (Phila). 2011 Nov;4(11):1799-807. doi: 10.1158/1940-6207.CAPR-11-0107. Epub 2011 Jul 15.
Adenomatous polyps are known precursor lesions for colorectal cancer and some hyperplastic polyps also have malignant potential. The use of aspirin and nonsteroidal anti-inflammatory drugs (NSAID) is associated with a reduced risk of adenomatous polyps; however, less evidence exists with regard to NSAID use and hyperplastic polyp risk. We conducted a colonoscopy-based case-control study including 2,028 polyp cases (1,529 adenomatous and 499 hyperplastic) and 3,431 polyp-free controls. Multivariate logistic regression models were constructed to derived adjusted ORs and 95% CIs as the measure of the association between NSAID use and polyp risk. Use of baby aspirin, regular aspirin, and nonaspirin NSAIDs, were associated with a reduced risk of adenomatous polyps (OR = 0.79, 95% CI: 0.66-0.93, OR = 0.73, 95% CI: 0.58-0.90, and OR = 0.67, 95% CI: 0.53-0.86, respectively). Baby aspirin was also associated with a reduced risk of hyperplastic polyps (OR = 0.74, 0.56-0.97). Although a dose response was seen with adenoma risk and regular use of any NSAIDs (less than 7 doses per week, 7 doses per week, and greater than 7 doses per week), a dose response was not seen with hyperplastic polyps. We found no evidence of interaction between NSAID dose and duration and polyp risk. The use of any NSAID regardless of type was associated with a reduced risk of adenomatous polyps; however, regular aspirin and COX-2 inhibitors use was not associated with hyperplastic polyp risk.
腺瘤性息肉是结直肠癌的已知前体病变，一些增生性息肉也具有恶性潜能。阿司匹林和非甾体抗炎药（NSAID）的使用与腺瘤性息肉风险降低相关；然而，关于 NSAID 使用与增生性息肉风险的证据较少。我们进行了一项基于结肠镜检查的病例对照研究，包括 2028 个息肉病例（1529 个腺瘤性和 499 个增生性）和 3431 个无息肉对照。构建多变量逻辑回归模型，得出调整后的 OR 和 95%CI，作为 NSAID 使用与息肉风险之间关联的衡量标准。使用小剂量阿司匹林、普通阿司匹林和非阿司匹林 NSAID 与腺瘤性息肉风险降低相关（OR=0.79，95%CI：0.66-0.93，OR=0.73，95%CI：0.58-0.90，OR=0.67，95%CI：0.53-0.86）。小剂量阿司匹林也与增生性息肉风险降低相关（OR=0.74，0.56-0.97）。虽然在腺瘤风险和任何 NSAID 的常规使用（每周少于 7 剂、每周 7 剂和每周大于 7 剂）之间观察到剂量反应，但在增生性息肉中未观察到剂量反应。我们没有发现 NSAID 剂量和持续时间与息肉风险之间存在交互作用的证据。无论 NSAID 类型如何，使用任何 NSAID 都与腺瘤性息肉风险降低相关；然而，普通阿司匹林和 COX-2 抑制剂的使用与增生性息肉风险无关。
