Usman Muhammad Waqas, Luo Fuwen, Cheng Hailing, Zhao Jean J, Liu Pixu
Cancer Institute, Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China; Institute of Cancer Stem Cell, Dalian Medical University, Dalian, Liaoning, China.
Department of Acute Abdomen Surgery, Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
Biochim Biophys Acta. 2015 Apr;1855(2):254-63. doi: 10.1016/j.bbcan.2015.03.007. Epub 2015 Apr 2.
Experimental, epidemiological, and clinical data from the last two decades have each supported the hypothesis that aspirin possesses anticancer properties, and that its use may also reduce the lifetime probability of developing or dying from a number of cancers. Aspirin's ability to act on multiple key metabolic and signaling pathways via inhibition of the cyclooxygenase (COX) enzyme, as well as through COX-independent mechanisms, makes it particularly relevant in the fight against cancer. A growing body of evidence indicates that aspirin may not only reduce cancer risk, but also prevent metastasis and angiogenesis while slowing the rate of mutation-inducing DNA damage. These emerging benefits of aspirin are offset to some extent by the known risks of treatment, such as cardiovascular events and gastrointestinal bleeding. However, it has been shown that pre-treatment risk assessment of individual patients and the use of proton pump inhibitors or Helicobacter pylori eradication therapy concomitantly with aspirin treatment can reduce these potential risks. Thus, the significant benefits of aspirin treatment, coupled with recent data concerning its risks, may prove to tip the balance in favor of aspirin use in cancer prevention.
过去二十年的实验、流行病学和临床数据均支持以下假说:阿司匹林具有抗癌特性,其使用还可能降低多种癌症的发病或死亡终生概率。阿司匹林能够通过抑制环氧化酶(COX)以及非COX依赖机制作用于多个关键代谢和信号通路,这使其在抗癌斗争中具有特殊意义。越来越多的证据表明,阿司匹林不仅可以降低癌症风险,还能预防转移和血管生成,同时减缓诱导突变的DNA损伤速率。阿司匹林这些新发现的益处,在一定程度上被已知的治疗风险所抵消,比如心血管事件和胃肠道出血。然而,研究表明,对个体患者进行治疗前风险评估,并在阿司匹林治疗的同时使用质子泵抑制剂或进行幽门螺杆菌根除治疗,可降低这些潜在风险。因此,阿司匹林治疗的显著益处,再加上近期有关其风险的数据,可能会使天平倾向于支持在癌症预防中使用阿司匹林。