Frouws M A, Bastiaannet E, Langley R E, Chia W K, van Herk-Sukel M P P, Lemmens V E P P, Putter H, Hartgrink H H, Bonsing B A, Van de Velde C J H, Portielje J E A, Liefers G J
Department of Surgical Oncology, Leiden University Medical Center, Leiden 2300 RC, The Netherlands.
MRC Clinical Trials Unit, University College London, Institute of Clinical Trials and Methodology, Aviation House 125 Kingsway, London WC2B 6NH, UK.
Br J Cancer. 2017 Jan;116(3):405-413. doi: 10.1038/bjc.2016.425. Epub 2017 Jan 10.
Previous studies suggested a relationship between aspirin use and mortality reduction. The mechanism for the effect of aspirin on cancer outcomes remains unclear. The aim of this study was to evaluate aspirin use and survival in patients with gastrointestinal tract cancer.
Patients with gastrointestinal tract cancer diagnosed between 1998 and 2011 were included. The population-based Eindhoven Cancer Registry was linked to drug-dispensing data from the PHARMO Database Network. The association between aspirin use after diagnosis and overall survival was analysed using Cox regression models.
In total, 13 715 patients were diagnosed with gastrointestinal cancer. A total of 1008 patients were identified as aspirin users, and 8278 patients were identified as nonusers. The adjusted hazard ratio for aspirin users vs nonusers was 0.52 (95% CI 0.44-0.63). A significant association between aspirin use and survival was observed for patients with oesophageal, hepatobiliary and colorectal cancer.
Post-diagnosis use of aspirin in patients with gastrointestinal tract malignancies is associated with increased survival in cancers with different sites of origin and biology. This adds weight to the hypothesis that the anti-cancer effects of aspirin are not tumour-site specific and may be modulated through the tumour micro-environment.
既往研究提示阿司匹林的使用与死亡率降低之间存在关联。阿司匹林对癌症结局产生影响的机制仍不清楚。本研究的目的是评估胃肠道癌症患者使用阿司匹林的情况及其生存率。
纳入1998年至2011年期间诊断为胃肠道癌症的患者。基于人群的埃因霍温癌症登记处与PHARMO数据库网络的药物配给数据相链接。使用Cox回归模型分析诊断后使用阿司匹林与总生存率之间的关联。
总共13715例患者被诊断为胃肠道癌。共有1008例患者被确定为阿司匹林使用者，8278例患者被确定为非使用者。阿司匹林使用者与非使用者的校正风险比为0.52（95%CI 0.44 - 0.63）。观察到阿司匹林的使用与食管癌、肝胆癌和结直肠癌患者的生存率之间存在显著关联。
胃肠道恶性肿瘤患者诊断后使用阿司匹林与不同起源部位和生物学特性的癌症患者生存率提高相关。这进一步支持了阿司匹林的抗癌作用并非肿瘤部位特异性的假说，且可能通过肿瘤微环境进行调节。
