Department of Medicine and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas.
Clin Gastroenterol Hepatol. 2015 Dec;13(13):2225-32. doi: 10.1016/j.cgh.2015.03.028. Epub 2015 Mar 31.
Esophageal adenocarcinoma has undergone a continuous rise in incidence since the early 1970s and is the fastest rising cancer among white men in the United States. Epidemiologic studies have demonstrated that medications commonly used to treat multiple chronic conditions (for example, aspirin, non-aspirin nonsteroidal anti-inflammatory drugs, and statins) as well as powerful acid suppressants such as proton pump inhibitors are associated with a reduced risk of esophageal adenocarcinoma. The chemopreventive potential of these classes of medications appears to be especially applicable to persons with Barrett's esophagus, the only known premalignant condition for esophageal adenocarcinoma. However, it is not known whether these medications also influence cancer recurrence and cancer-specific mortality in persons diagnosed with esophageal adenocarcinoma. This is an important question because most patients with esophageal adenocarcinoma have 1 or more comorbid conditions at the time of their cancer diagnosis and are receiving medication to treat these conditions. This article summarizes the evidence on the associations between 4 commonly used classes of medications and (1) risk of developing esophageal adenocarcinoma and Barrett's esophagus and (2) risk of cancer recurrence and cancer-specific mortality in patients with esophageal adenocarcinoma.
自 20 世纪 70 年代初以来，食管腺癌的发病率持续上升，是美国白人男性中发病率上升最快的癌症。流行病学研究表明，常用于治疗多种慢性疾病的药物（如阿司匹林、非阿司匹林非甾体抗炎药和他汀类药物）以及强效胃酸抑制剂如质子泵抑制剂，与食管腺癌风险降低有关。这些类别的药物的化学预防潜力似乎特别适用于 Barrett 食管患者，Barrett 食管是食管腺癌唯一已知的癌前病变。然而，尚不清楚这些药物是否也会影响诊断出患有食管腺癌的患者的癌症复发和癌症特异性死亡率。这是一个重要的问题，因为大多数食管腺癌患者在诊断出癌症时都有 1 种或多种合并症，并且正在服用药物来治疗这些疾病。本文总结了 4 种常用药物类别与（1）发展为食管腺癌和 Barrett 食管的风险，以及（2）食管腺癌患者的癌症复发和癌症特异性死亡率之间关联的证据。
