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非甾体抗炎药使用与脑肿瘤风险:临床实践研究数据库中的病例对照研究。

Non-steroidal anti-inflammatory drug use and brain tumour risk: a case-control study within the Clinical Practice Research Datalink.

机构信息

Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK,

出版信息

Cancer Causes Control. 2013 Nov;24(11):2027-34. doi: 10.1007/s10552-013-0279-9. Epub 2013 Aug 30.

Abstract

PURPOSE

The aetiology of primary brain tumours is largely unknown; the role of non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin use and glioma risk has been inconclusive, but few population-based studies with reliable prescribing data have been conducted, and the association with meningioma risk has yet to be assessed.

METHODS

The UK Clinical Practice Research Datalink was used to assess the association between aspirin and non-aspirin NSAID use and primary brain tumour risk using a nested case-control study design. Conditional logistic regression analysis was performed on 5,052 brain tumour patients aged 16 years and over, diagnosed between 1987 and 2009 and 42,678 controls matched on year of birth, gender and general practice, adjusting for history of allergy and hormone replacement therapy use in the glioma and meningioma models, respectively.

RESULTS

In conditional logistic regression analysis, excluding drug use in the year preceding the index date, there was no association with non-aspirin NSAID use (OR 0.96, 95 % CI 0.81-1.13) or glioma risk comparing the highest category of daily defined dose to non-users; however, non-aspirin NSAID use was positively associated with meningioma risk (OR 1.35, 95 % CI 1.06-1.71). No association was seen with high- or low-dose aspirin use irrespective of histology.

CONCLUSIONS

This large nested case-control study finds no association between aspirin or non-aspirin NSAID use and risk of glioma but a slight increased risk with non-aspirin NSAIDs and meningioma.

摘要

目的

原发性脑瘤的病因在很大程度上尚不清楚;非甾体抗炎药(NSAIDs)或阿司匹林的使用与胶质瘤风险之间的关系尚无定论,但很少有基于人群且具有可靠处方数据的研究,并且脑膜瘤风险的相关性尚未得到评估。

方法

利用英国临床实践研究数据链,采用巢式病例对照研究设计,评估阿司匹林和非阿司匹林 NSAID 使用与原发性脑瘤风险之间的关联。对 1987 年至 2009 年间诊断出的 5052 名年龄在 16 岁及以上的脑肿瘤患者和 42678 名按出生年份、性别和全科医生匹配的对照进行了条件逻辑回归分析,分别调整了胶质瘤和脑膜瘤模型中过敏和激素替代疗法使用的病史。

结果

在条件逻辑回归分析中,排除索引日期前一年的药物使用情况,与非阿司匹林 NSAID 使用(OR 0.96,95%CI 0.81-1.13)或比较最高每日剂量类别与非使用者的胶质瘤风险之间无关联;然而,非阿司匹林 NSAID 与脑膜瘤风险呈正相关(OR 1.35,95%CI 1.06-1.71)。无论组织学如何,高剂量或低剂量阿司匹林的使用均与风险无关。

结论

这项大型巢式病例对照研究发现,阿司匹林或非阿司匹林 NSAID 使用与胶质瘤风险之间无关联,但与非阿司匹林 NSAIDs 和脑膜瘤之间存在轻微的风险增加。

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