氢氯噻嗪的使用与 Merkel 细胞癌和恶性附属器皮肤肿瘤的风险：一项全国性病例对照研究。
Hydrochlorothiazide use and risk for Merkel cell carcinoma and malignant adnexal skin tumors: A nationwide case-control study.
机构信息
Department of Neurology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
出版信息
J Am Acad Dermatol. 2019 Feb;80(2):460-465.e9. doi: 10.1016/j.jaad.2018.06.014. Epub 2018 Jun 18.
BACKGROUND
Hydrochlorothiazide use has been associated with markedly increased risk for squamous cell carcinoma. No previous studies have investigated the association between hydrochlorothiazide use and the risk for Merkel cell carcinoma (MCC) and malignant adnexal skin tumors (MAST).
OBJECTIVE
To examine the association between hydrochlorothiazide use and the risk for MCC and MAST.
METHODS
Using Danish nationwide health registries, we identified all patients with incident MCC or MAST during 2004-2015 and matched the cases individually to cancer-free population controls by risk set sampling. Using conditional logistic regression, we estimated the odds ratios (ORs) and confidence intervals (CIs) associated with cumulative use of hydrochlorothiazide.
RESULTS
The adjusted ORs for MCC and MAST associated with high use (≥50,000 mg) of hydrochlorothiazide was 2.3 (95% CI 1.1-4.8) and 3.6 (95% CI 1.9-7.0), respectively, which increased to 3.3 (95% CI 1.3-8.3) and 5.6 (95% CI 2.4-13.3), respectively, with highest use (≥100,000 mg). We found no increased risk for these tumors in analyses of drugs with similar indications as hydrochlorothiazide, except there was a tendency toward an increased risk for MCC associated with the use of furosemide (OR 1.9, 95% CI 0.9-4.0).
LIMITATIONS
No data on sun exposure was available.
CONCLUSION
Hydrochlorothiazide use is associated with an increased risk for MCC and MAST.
背景
氢氯噻嗪的使用与鳞状细胞癌的风险显著增加有关。以前没有研究调查氢氯噻嗪的使用与 Merkel 细胞癌 (MCC) 和恶性附属器皮肤肿瘤 (MAST) 风险之间的关系。
目的
研究氢氯噻嗪的使用与 MCC 和 MAST 风险之间的关系。
方法
使用丹麦全国健康登记处，我们确定了 2004-2015 年期间所有患有 MCC 或 MAST 的患者，并通过风险集抽样对这些患者进行了个体匹配的无癌症人群对照。使用条件逻辑回归，我们估计了与氢氯噻嗪累积使用相关的比值比 (OR) 和置信区间 (CI)。
结果
与高剂量 (≥50,000 毫克) 氢氯噻嗪使用相关的 MCC 和 MAST 的调整后 OR 分别为 2.3 (95%CI 1.1-4.8) 和 3.6 (95%CI 1.9-7.0)，当剂量增加至最高剂量 (≥100,000 毫克) 时，分别增至 3.3 (95%CI 1.3-8.3) 和 5.6 (95%CI 2.4-13.3)。在分析具有类似氢氯噻嗪适应症的药物时，我们没有发现这些肿瘤的风险增加，但发现使用呋塞米与 MCC 风险增加有关 (OR 1.9，95%CI 0.9-4.0)。
局限性
没有关于阳光暴露的数据。
结论
氢氯噻嗪的使用与 MCC 和 MAST 的风险增加有关。
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