Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gröna stråket 16, SE-413 45 Gothenburg, Sweden.
Acta Derm Venereol. 2018 Oct 10;98(9):888-895. doi: 10.2340/00015555-2987.
Methotrexate treatment has been linked with an increased risk of melanoma. However, a possible dose-response relationship with respect to methotrexate exposure and melanoma has not been addressed. The aim of the present study was to investigate whether higher accumulated doses of methotrexate correlate with an increased risk of melanoma, which would further support a possible association. A nationwide retrospective cohort study was conducted. All Swedish patients over 18 years of age who were dispensed methotrexate in the period 2005 to 2014 were registered (n = 101,966) and matched to the cancer registry. A Cox proportional hazards model, testing risk of melanoma vs. total accumulated methotrexate dose, controlled for sex, age group, and time from first to last dispensed prescription of methotrexate, yielded no significant risk dependence on dose, and a hazard ratio of 1.02 (95% CI 0.97-1.08). Overall, no conclusive dose-response relationship was observed between methotrexate exposure and risk of melanoma.
甲氨蝶呤治疗与黑色素瘤风险增加有关。然而，甲氨蝶呤暴露与黑色素瘤之间是否存在剂量反应关系尚未得到解决。本研究旨在调查累积甲氨蝶呤剂量是否与黑色素瘤风险增加相关，这将进一步支持两者之间的可能关联。进行了一项全国性回顾性队列研究。所有在 2005 年至 2014 年期间接受甲氨蝶呤治疗的 18 岁以上瑞典患者均进行了登记（n=101966），并与癌症登记处进行了匹配。Cox 比例风险模型测试了黑色素瘤与总累积甲氨蝶呤剂量之间的风险，控制了性别、年龄组以及首次至最后一次开具甲氨蝶呤处方之间的时间，结果显示剂量与风险之间没有显著的依赖关系，风险比为 1.02（95%CI 0.97-1.08）。总体而言，在甲氨蝶呤暴露与黑色素瘤风险之间未观察到明确的剂量反应关系。
