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使用非那雄胺或口服避孕药进行激素调控不会影响肾细胞癌的发病率。

Hormonal manipulation with finasteride or oral contraception does not influence incidence of renal cell carcinoma.

作者信息

Kabra Aashish, Gelfond Jonathan, Liss Michael A

机构信息

Departments of Urology.

Biostatistics, University of Texas Health Science Center San Antonio.

出版信息

Eur J Cancer Prev. 2018 Sep;27(5):449-452. doi: 10.1097/CEJ.0000000000000345.

Abstract

Androgens have been suspected to be involved in the initiation of renal cell carcinoma because of a two-fold increased risk in men compared with women. To investigate the role of self-reported finasteride or oral contraceptive use in the Prostate, Lung, Colorectal, and Ovarian (PCLO) to determine whether the androgen receptor reduces renal cancer development. We query the PCLO trial for predictor variables from the baseline questionnaire and follow-up questionnaires enquiring medication use, specifically the use of 5-α reductase inhibitors (dutasteride or finasteride) and oral contraceptive therapy. The primary outcome of this study was the incidence of renal cancer. Statistical analysis included Student's t-test for continuous variables, χ, or Fisher's exact tests for dichotomous or categorical variables, and multivariable analysis using Cox proportional hazards models. Eight percent (n=6117/73 694) of men in the PCLO trial reported the use of finasteride. 52 (10.6%) of the 492 men diagnosed with renal cancer had self-reported exposure to finasteride and this was not significant in univariable analysis (52/6169; 0.84% vs. 440/66 454; 0.67%, P=0.12) or multivariable main effects analysis (hazard ratio: 1.12; 95% confidence interval: 0.83-1.5; P=0.47). Approximately 54% of women (n=40 997/75 989) in the PCLO trial reported the use of oral contraceptives by questionnaire. 136 (52.1%) of the 261 women diagnosed with renal cancer had self-reported exposure to oral contraceptive therapy and this was not significant in univariable analysis (136/40 997; 0.33% vs. 125/34 992; 0.36%, P=0.36) or in multivariable main effects analysis (hazard ratio: 1.03; 95% confidence interval: 0.97-1.1; P=0.30). Self-reported use of finasteride or oral contraceptives is not associated with a reduced incidence of renal cancer.

摘要

由于男性患肾细胞癌的风险是女性的两倍,雄激素一直被怀疑与肾细胞癌的发病有关。为了研究在前列腺、肺、结肠直肠和卵巢癌(PCLO)试验中自我报告的非那雄胺或口服避孕药的使用情况,以确定雄激素受体是否能降低肾癌的发生风险。我们从基线调查问卷和询问用药情况的随访调查问卷中查询PCLO试验的预测变量,特别是5-α还原酶抑制剂(度他雄胺或非那雄胺)和口服避孕药治疗的使用情况。本研究的主要结局是肾癌的发病率。统计分析包括对连续变量进行Student's t检验,对二分或分类变量进行χ检验或Fisher精确检验,以及使用Cox比例风险模型进行多变量分析。PCLO试验中8%(n=6117/73694)的男性报告使用过非那雄胺。在492名被诊断为肾癌的男性中,有52名(10.6%)自我报告曾接触过非那雄胺,这在单变量分析中无显著差异(52/6169;0.84%对440/66454;0.67%,P=0.12)或多变量主效应分析中也无显著差异(风险比:1.12;95%置信区间:0.83-1.5;P=0.47)。PCLO试验中约54%(n=40997/75989)的女性通过问卷调查报告使用过口服避孕药。在261名被诊断为肾癌的女性中,有136名(52.1%)自我报告曾接触过口服避孕药治疗,这在单变量分析中无显著差异(136/40997;0.33%对125/34992;0.36%,P=0.36)或多变量主效应分析中也无显著差异(风险比:1.03;95%置信区间:0.97-1.1;P=0.30)。自我报告使用非那雄胺或口服避孕药与肾癌发病率降低无关。

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