Patel Dhaval, Kitahara Cari M, Park Yikyung, Liao Linda M, Linet Martha, Kebebew Electron, Nilubol Naris
1 Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health , Bethesda, Maryland.
2 Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health , Bethesda, Maryland.
Thyroid. 2015 Dec;25(12):1355-62. doi: 10.1089/thy.2015.0198. Epub 2015 Nov 12.
Cyclooxygenase (COX-2) has been associated with tumor growth and metastasis in several cancers, including thyroid cancer. For this reason, several investigators have studied COX-2 inhibitors in preclinical models of thyroid cancer and found antineoplastic effects. Thus, the primary aim of this study was to assess if the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced incidence of thyroid cancer. A second aim of the study was to determine additional risk or protective factors for thyroid cancer.
Three large prospective population-based studies (the NIH-AARP Diet and Health Study; the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial; and the U.S. Radiologic Technologists Study) were pooled to investigate the association between self-reported frequency of aspirin and nonaspirin NSAID use one year prior to baseline (no use, ≤ 2/week, >2-6/week, and ≥ 7/week) and subsequent risk of thyroid cancer. A Cox regression proportional hazard model was used to estimate aggregated hazard ratios (HR) adjusted for cohort, sex, race/ethnicity, weight, smoking status, and alcohol intake.
There were 388,577 participants in the pooled cohort, with 481 cases of thyroid cancer. No significant risk reduction was observed with regular use of nonaspirin NSAIDs (HR = 1.14 [confidence interval (CI) 0.84-1.55]), and/or regular use of aspirin (HR = 1.06 [CI 0.82-1.39]). The multivariate regression analysis confirmed as previously reported in the literature that female sex, obesity class I (body mass index [BMI] = 30-34.99 kg/m(2)), and obesity class II (BMI = 35-35.99 kg/m(2)) were independently associated with an increased thyroid cancer risk. Current smoking status and moderate and excessive alcohol use were also confirmed as independent risk factors associated with a reduced thyroid cancer risk.
Neither nonaspirin NSAIDs nor aspirin use is associated with a reduced risk of thyroid cancer. Women and obesity are associated with an increased risk of thyroid cancer, whereas smoking and alcohol use are associated with decreased risk of thyroid cancer.
环氧化酶（COX - 2）与包括甲状腺癌在内的多种癌症的肿瘤生长和转移有关。因此，一些研究人员在甲状腺癌的临床前模型中研究了COX - 2抑制剂，并发现了抗肿瘤作用。因此，本研究的主要目的是评估使用非甾体抗炎药（NSAIDs）是否与甲状腺癌发病率降低有关。该研究的第二个目的是确定甲状腺癌的其他风险或保护因素。
汇总三项大型基于人群的前瞻性研究（美国国立卫生研究院 - 美国退休人员协会饮食与健康研究；前列腺、肺、结肠和卵巢癌筛查试验；以及美国放射技师研究），以调查基线前一年自我报告的阿司匹林和非阿司匹林NSAIDs使用频率（不使用、≤每周2次、>2 - 6次/周和≥7次/周）与随后患甲状腺癌风险之间的关联。使用Cox回归比例风险模型来估计经队列、性别、种族/族裔、体重、吸烟状况和酒精摄入量调整后的汇总风险比（HR）。
汇总队列中有388,577名参与者，其中481例甲状腺癌病例。未观察到定期使用非阿司匹林NSAIDs（HR = 1.14[置信区间（CI）0.84 - 1.55]）和/或定期使用阿司匹林（HR = 1.06[CI 0.82 - 1.39]）有显著的风险降低。多变量回归分析证实，如文献中先前报道的那样，女性、I类肥胖（体重指数[BMI] = 30 - 34.99 kg/m²）和II类肥胖（BMI = 35 - 35.99 kg/m²）与甲状腺癌风险增加独立相关。当前吸烟状况以及中度和过量饮酒也被确认为与甲状腺癌风险降低相关的独立危险因素。
使用非阿司匹林NSAIDs和阿司匹林均与甲状腺癌风险降低无关。女性和肥胖与甲状腺癌风险增加有关，而吸烟和饮酒与甲状腺癌风险降低有关。
