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抗抑郁药的使用与上皮性卵巢癌风险。

Use of antidepressants and risk of epithelial ovarian cancer.

机构信息

Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark.

Department of Gynecology, Rigshospitalet, University of Copenhagen, DK-2100, Copenhagen, Denmark.

出版信息

Int J Cancer. 2017 Dec 1;141(11):2197-2203. doi: 10.1002/ijc.30919. Epub 2017 Aug 18.

Abstract

Antidepressants are widely prescribed among women to treat depression and anxiety disorders, but studies of their effects on gynecological cancer risk are sparse. We assessed associations between various antidepressants and risk of epithelial ovarian cancer. By using Danish nationwide registers, we identified all women (cases) aged 30-84 years with incident epithelial (serous, endometrioid, clear cell or mucinous) ovarian cancer during 2000-2011 (n = 4,103) and matched each case to 20 population controls (n = 58,706) by risk-set matching. Data on drug use (including tricyclic and related antidepressants, selective serotonin reuptake inhibitors, other antidepressants, and potential confounder drugs), medical and reproductive history and socioeconomic parameters, were obtained from nationwide registries. We used conditional logistic regression models to estimate adjusted odds ratios (ORs) and two-sided 95% confidence intervals (CIs) for epithelial ovarian cancer associated with antidepressive drug use. Compared with non-use, use of selective serotonin reuptake inhibitors was associated with a decreased risk of ovarian cancer (OR, 0.85; 95% CI, 0.74-0.96), whereas the associations for other antidepressants were close to unity [tricyclic and related antidepressants: OR, 0.99 (95% CI, 0.78-1.26); other antidepressants: OR, 1.05 (95% CI, 0.76-1.46)]. For individual types of SSRI, reduced ORs were observed for citalopram OR, 0.78 (95% CI, 0.66-0.93), paroxetine 0.79 (95% CI, 0.56-1.12) and sertraline 0.80 (95% CI, 0.60-1.08). Among postmenopausal women, the inverse association was restricted to users of menopausal hormone therapy. In conclusion, use of selective serotonin reuptake inhibitors was associated with a decreased risk of epithelial ovarian cancer; thereby implying potential chemopreventive properties of these drugs.

摘要

抗抑郁药被广泛用于治疗女性的抑郁症和焦虑症,但关于它们对妇科癌症风险的影响的研究却很少。我们评估了各种抗抑郁药与上皮性卵巢癌风险之间的关联。我们利用丹麦全国性登记系统,确定了 2000 年至 2011 年期间所有年龄在 30-84 岁之间患有上皮性(浆液性、子宫内膜样、透明细胞或黏液性)卵巢癌的女性(病例)(n=4103),并通过风险集匹配,为每个病例匹配了 20 名人群对照(n=58706)。药物使用(包括三环类和相关抗抑郁药、选择性 5-羟色胺再摄取抑制剂、其他抗抑郁药和潜在混杂药物)、医疗和生殖史以及社会经济参数的数据来自全国性登记系统。我们使用条件逻辑回归模型,估计与抗抑郁药使用相关的上皮性卵巢癌的调整后比值比(OR)和双侧 95%置信区间(CI)。与不使用相比,使用选择性 5-羟色胺再摄取抑制剂与卵巢癌风险降低相关(OR,0.85;95%CI,0.74-0.96),而其他抗抑郁药的相关性接近 1.0 [三环类和相关抗抑郁药:OR,0.99(95%CI,0.78-1.26);其他抗抑郁药:OR,1.05(95%CI,0.76-1.46)]。对于个体类型的 SSRI,西酞普兰的 OR 降低(OR,0.78;95%CI,0.66-0.93)、帕罗西汀(OR,0.79;95%CI,0.56-1.12)和舍曲林(OR,0.80;95%CI,0.60-1.08)的 OR 降低。在绝经后妇女中,这种反比关联仅限于使用绝经激素治疗的妇女。总之,使用选择性 5-羟色胺再摄取抑制剂与上皮性卵巢癌风险降低相关;这意味着这些药物具有潜在的化学预防特性。

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