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他莫昔芬与亚洲乳腺癌女性患者患帕金森病的风险:一项基于全国人口的研究。

Tamoxifen and the Risk of Parkinson's Disease in Female Patients with Breast Cancer in Asian People: A Nationwide Population-Based Study.

作者信息

Hong Chien-Tai, Chan Lung, Hu Chaur-Jong, Lin Chien-Min, Hsu Chien-Yeh, Lin Ming-Chin

机构信息

Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Department of Neurology, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

J Breast Cancer. 2017 Dec;20(4):356-360. doi: 10.4048/jbc.2017.20.4.356. Epub 2017 Dec 19.

Abstract

PURPOSE

Whether tamoxifen affects the risk of neurodegenerative disease is controversial. This nationwide population-based study investigated the risk of Parkinson's disease (PD) associated with tamoxifen treatment in female patients with breast cancer using Taiwan's National Health Insurance Research Database.

METHODS

A total of 5,185 and 5,592 female patients with breast cancer who did and did not, respectively, receive tamoxifen treatment between 2000 and 2009 were included in the study. Patients who subsequently developed PD were identified. A Cox proportional hazards model was used to compare the risk of PD between the aforementioned groups.

RESULTS

Tamoxifen did not significantly increase the crude rate of developing PD in female patients with breast cancer (tamoxifen group, 16/5,169; non-tamoxifen group, 11/5,581; =0.246). Tamoxifen did not significantly increase the adjusted hazard ratio (aHR) for subsequently developing PD (aHR, 1.310; 95% confidence interval [CI], 0.605-2.837; =0.494). However, tamoxifen significantly increased the risk of PD among patients followed up for more than 6 years (aHR, 2.435; 95% CI, 1.008-5.882; =0.048).

CONCLUSION

Tamoxifen treatment may increase the risk of PD in Taiwanese female patients with breast cancer more than 6 years after the initiation of treatment.

摘要

目的

他莫昔芬是否会影响神经退行性疾病的风险存在争议。这项基于全国人口的研究利用台湾国民健康保险研究数据库,调查了接受他莫昔芬治疗的女性乳腺癌患者患帕金森病(PD)的风险。

方法

该研究纳入了2000年至2009年间分别接受和未接受他莫昔芬治疗的5185名和5592名女性乳腺癌患者。确定随后发生PD的患者。使用Cox比例风险模型比较上述两组发生PD的风险。

结果

他莫昔芬并未显著增加女性乳腺癌患者发生PD的粗发病率(他莫昔芬组,16/5169;非他莫昔芬组,11/5581;P=0.246)。他莫昔芬并未显著增加随后发生PD的调整后风险比(aHR,1.310;95%置信区间[CI],0.605-2.837;P=0.494)。然而,他莫昔芬显著增加了随访超过6年的患者发生PD的风险(aHR,2.435;95%CI,1.008-5.882;P=0.048)。

结论

在台湾女性乳腺癌患者中,他莫昔芬治疗开始6年多后可能会增加患PD的风险。

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1
Tamoxifen Induces Cytotoxic Autophagy in Glioblastoma.他莫昔芬诱导胶质母细胞瘤中的细胞毒性自噬。
J Neuropathol Exp Neurol. 2016 Oct;75(10):946-954. doi: 10.1093/jnen/nlw071. Epub 2016 Aug 11.
2
Inverse Association Between Cancer and Dementia: A Population-based Registry Study in Taiwan.
Alzheimer Dis Assoc Disord. 2016 Apr-Jun;30(2):118-22. doi: 10.1097/WAD.0000000000000116.
4
Lifetime exposure to estrogens and Parkinson's disease in California teachers.加利福尼亚州教师的雌激素终生暴露与帕金森病
Parkinsonism Relat Disord. 2014 Nov;20(11):1149-56. doi: 10.1016/j.parkreldis.2014.08.003. Epub 2014 Aug 19.
5
Mitochondria: the gateway for tamoxifen-induced liver injury.线粒体:他莫昔芬诱导肝损伤的门户。
Toxicology. 2014 Sep 2;323:10-8. doi: 10.1016/j.tox.2014.05.009. Epub 2014 Jun 2.
8
Parkinson's disease: evidence for environmental risk factors.帕金森病:环境风险因素的证据。
Mov Disord. 2013 Jan;28(1):8-13. doi: 10.1002/mds.25150. Epub 2012 Oct 24.

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