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使用β受体阻滞剂与卵巢癌诊断后的死亡率:基于人群的队列研究。

Use of ß-blockers and mortality following ovarian cancer diagnosis: a population-based cohort study.

机构信息

Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA.

出版信息

BMC Cancer. 2013 Feb 22;13:85. doi: 10.1186/1471-2407-13-85.

Abstract

BACKGROUND

Experimental data suggest that catecholamine hormones are involved in stimulating the aggressiveness of ovarian cancer, but few population-based studies have examined this association. We therefore conducted a population-based cohort study to examine whether ß-blockers affect mortality following ovarian cancer diagnosis.

METHODS

We used the Danish Cancer Registry to identify all patients diagnosed with ovarian cancer in northern Denmark between 1999 and 2010 (n=6,626). Data on medication use, comorbidity, and survival were obtained from medical databases. According to the last redeemed prescription before diagnosis, ß-blocker use was categorized as current (within ≤90 days), previous (>90 days) or never. We used Cox proportional hazards regression to calculate hazard ratios (HRs) for all-cause mortality with 95% confidence intervals (CIs) adjusting for confounding factors.

RESULTS

Among the ovarian cancer patients, 373 (5.6%) were current, 87 (1.3%) previous, and 6,166 (93.1%) were nonusers of ß-blockers. Median duration of use was 19.0 months among current users and 43.0 months among previous users. Median follow-up was 2.55 years (IQR: 0.81-9.23). Nonusers and current users of ß-blockers had similar comorbidity burden whereas previous users had moderate comorbidity more frequently. Compared with nonusers, the adjusted HR was 1.17 (95% CI: 1.02-1.34) for current users and 1.18 (95% CI: 0.90-1.55) for previous users. Secondary analyses stratifying by cancer stage and duration of ß-blocker use supported the overall results.

CONCLUSIONS

We found no evidence that ß-blocker use was associated with decreased mortality following ovarian cancer diagnosis.

摘要

背景

实验数据表明,儿茶酚胺激素参与刺激卵巢癌的侵袭性,但很少有基于人群的研究对此关联进行了检验。因此,我们开展了一项基于人群的队列研究,以检验β受体阻滞剂是否会影响卵巢癌诊断后的死亡率。

方法

我们使用丹麦癌症登记处确定了 1999 年至 2010 年期间在丹麦北部诊断出的所有卵巢癌患者(n=6626)。用药、合并症和生存数据来自医疗数据库。根据诊断前最后一次处方的使用情况,将β受体阻滞剂的使用分为当前(≤90 天内)、以前(>90 天)或从未使用过。我们使用 Cox 比例风险回归计算了全因死亡率的风险比(HR)及其 95%置信区间(CI),并调整了混杂因素。

结果

在卵巢癌患者中,373 例(5.6%)为当前使用者,87 例(1.3%)为以前使用者,6166 例(93.1%)为非使用者。当前使用者的使用中位时间为 19.0 个月,以前使用者的使用中位时间为 43.0 个月。中位随访时间为 2.55 年(IQR:0.81-9.23)。β受体阻滞剂的非使用者和当前使用者的合并症负担相似,而以前使用者更常患有中度合并症。与非使用者相比,当前使用者的调整 HR 为 1.17(95%CI:1.02-1.34),以前使用者的调整 HR 为 1.18(95%CI:0.90-1.55)。按癌症分期和β受体阻滞剂使用时间分层的二次分析支持了总体结果。

结论

我们没有发现β受体阻滞剂的使用与卵巢癌诊断后死亡率降低相关的证据。

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