Vogtmann Emily, Corley Douglas A, Almers Lucy M, Cardwell Chris R, Murray Liam J, Abnet Christian C
Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America; Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
Division of Research, Kaiser Permanente, Oakland, California, United States of America.
PLoS One. 2015 Oct 7;10(10):e0140180. doi: 10.1371/journal.pone.0140180. eCollection 2015.
The association between oral bisphosphonate use and upper gastrointestinal cancer has been controversial. Therefore, we examined the association with esophageal and gastric cancer within the Kaiser Permanente, Northern California population. A total of 1,011 cases of esophageal (squamous cell carcinoma and adenocarcinoma) and 1,923 cases of gastric adenocarcinoma (cardia, non-cardia and other) diagnosed between 1997 and 2011 from the Kaiser Permanente, Northern California cancer registry were matched to 49,886 and 93,747 controls, respectively. Oral bisphosphonate prescription fills at least one year prior to the index date were extracted. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between prospectively evaluated oral bisphosphonate use with incident esophageal and gastric cancer diagnoses with adjustment for potential confounders. After adjustment for potential confounders, no significant associations were found for esophageal squamous cell carcinoma (OR 0.88; 95% CI: 0.51, 1.52), esophageal adenocarcinoma (OR 0.68; 95% CI: 0.37, 1.24), or gastric non-cardia adenocarcinoma (OR 0.83, 95% CI: 0.59, 1.18), but we observed an adverse association with gastric cardia adenocarcinoma (OR 1.64; 95% CI: 1.07, 2.50). In conclusion, we observed no association between oral bisphosphonate use and esophageal cancer risk within a large community-based population. A significant association was detected with gastric cardia and other adenocarcinoma risk, although this needs to be replicated.
口服双膦酸盐类药物的使用与上消化道癌症之间的关联一直存在争议。因此，我们在北加利福尼亚州凯撒医疗集团的人群中研究了其与食管癌和胃癌的关联。从北加利福尼亚州凯撒医疗集团癌症登记处选取了1997年至2011年间诊断的1011例食管癌（鳞状细胞癌和腺癌）病例以及1923例胃腺癌（贲门癌、非贲门癌和其他类型）病例，分别与49886名和93747名对照进行匹配。提取索引日期前至少一年的口服双膦酸盐类药物处方记录。采用条件逻辑回归计算前瞻性评估的口服双膦酸盐类药物使用与食管癌和胃癌确诊之间关联的比值比（OR）及95%置信区间（95%CI），并对潜在混杂因素进行校正。校正潜在混杂因素后，未发现口服双膦酸盐类药物与食管鳞状细胞癌（OR 0.88；95%CI：0.51，1.52）、食管腺癌（OR 0.68；95%CI：0.37，1.24）或胃非贲门腺癌（OR 0.83，95%CI：0.59，1.18）之间存在显著关联，但我们观察到其与胃贲门腺癌存在不良关联（OR 1.64；95%CI：1.07，2.50）。总之，在一个大型社区人群中，我们未发现口服双膦酸盐类药物的使用与食管癌风险之间存在关联。虽然需要重复验证，但已检测到其与胃贲门癌和其他腺癌风险之间存在显著关联。
