Chang Ping-Ying, Huang Wen-Yen, Lin Cheng-Li, Huang Tzu-Chuan, Wu Yi-Ying, Chen Jia-Hong, Kao Chia-Hung
From the Division of Hematology/Oncology, Department of Internal Medicine (P-YC, T-CH, Y-YWu, J-HC); Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center (W-YH); Institute of Clinical Medicine, National Yang-Ming University, Taipei (W-YH); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine (C-LL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (C-HK); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Medicine (Baltimore). 2015 Jul;94(27):e1097. doi: 10.1097/MD.0000000000001097.
β-Blockers have been reported to exhibit potential anticancer effects in cancer cell lines and animal models. However, clinical studies have yielded inconsistent results regarding cancer outcomes and cancer risk when β-blockers were used. This study investigated the association between propranolol and cancer risk.Between January 1, 2000 and December 31, 2011, a patient cohort was extracted from the Longitudinal Health Insurance Database 2000, a subset of the Taiwan National Health Insurance Research Database. A propranolol cohort (propranolol usage >6 months) and nonpropranolol cohort were matched using a propensity score. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of cancer associated with propranolol treatment.The study sample comprised 24,238 patients. After a 12-year follow-up period, the cumulative incidence for developing cancer was low in the propranolol cohort (HR: 0.75; 95% CI: 0.67-0.85; P < 0.001). Patients with propranolol treatment exhibited significantly lower risks of cancers in head and neck (HR: 0.58; 95% CI: 0.35-0.95), esophagus (HR: 0.35; 95% CI: 0.13-0.96), stomach (HR: 0.54; 95% CI: 0.30-0.98), colon (HR: 0.68; 95% CI: 0.49-0.93), and prostate cancers (HR: 0.52; 95% CI: 0.33-0.83). The protective effect of propranolol for head and neck, stomach, colon, and prostate cancers was most substantial when exposure duration exceeded 1000 days.This study supports the proposition that propranolol can reduce the risk of head and neck, esophagus, stomach, colon, and prostate cancers. Further prospective study is necessary to confirm these findings.
据报道,β受体阻滞剂在癌细胞系和动物模型中显示出潜在的抗癌作用。然而,关于使用β受体阻滞剂时的癌症结局和癌症风险,临床研究结果并不一致。本研究调查了普萘洛尔与癌症风险之间的关联。
在2000年1月1日至2011年12月31日期间,从台湾国民健康保险研究数据库的一个子集——2000年纵向健康保险数据库中提取了一个患者队列。使用倾向评分匹配了一个普萘洛尔队列(普萘洛尔使用时间>6个月)和非普萘洛尔队列。使用Cox比例风险模型估计与普萘洛尔治疗相关的癌症的风险比(HR)和95%置信区间(CI)。
研究样本包括24238名患者。经过12年的随访期,普萘洛尔队列中患癌的累积发生率较低(HR:0.75;95%CI:0.67-0.85;P<0.001)。接受普萘洛尔治疗的患者在头颈部(HR:0.58;95%CI:0.35-0.95)、食管(HR:0.35;95%CI:0.13-0.96)、胃(HR:0.54;95%CI:0.30-0.98)、结肠(HR:0.68;95%CI:0.49-0.93)和前列腺癌(HR:0.52;95%CI:0.33-0.83)方面的风险显著较低。当暴露持续时间超过1000天时,普萘洛尔对头颈部、胃、结肠和前列腺癌的保护作用最为显著。
本研究支持普萘洛尔可降低头颈部、食管、胃、结肠和前列腺癌风险这一观点。需要进一步的前瞻性研究来证实这些发现。