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他汀类药物的使用与对侧乳腺癌风险:一项全国性队列研究。

Statin use and risk of contralateral breast cancer: a nationwide cohort study.

机构信息

Danish Cancer Society Research Center, Copenhagen, Denmark.

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Br J Cancer. 2018 Nov;119(10):1297-1305. doi: 10.1038/s41416-018-0252-1. Epub 2018 Oct 24.

Abstract

BACKGROUND

Statins have demonstrated antineoplastic effects in breast cancer cell lines, particularly in oestrogen receptor (ER)-negative cell lines. However, epidemiological studies have not supported a preventive effect of statin use against breast cancer. Therefore, we examined the association between statin use and contralateral breast cancer (CBC) risk among women with breast cancer.

METHODS

We identified 52,723 women with non-metastatic breast cancer during 1996-2012 from the Danish Breast Cancer Group database. We defined time-varying post-diagnosis statin use as minimum two prescriptions lagged by 1 year. Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CBC associated with statin use.

RESULTS

Statin use was associated with a lower CBC risk (HR = 0.88; 95% CI = 0.73-1.05). The inverse association was strongest for long-term use overall (HR = 0.64; 95% CI = 0.43-0.96), although the HR specifically for long-term consistent use and high-intensity use approached unity. Among ER-negative breast cancer patients, statin use was associated with a CBC risk reduction (HR = 0.67; 95% CI = 0.45-1.00).

CONCLUSIONS

We found some indication that statins reduce the risk of CBC. Further evaluations are needed to disentangle the equivocal results for long-term use and to establish if ER-negative breast cancer patients may benefit most from statin use.

摘要

背景

他汀类药物在乳腺癌细胞系中表现出抗肿瘤作用,尤其是在雌激素受体(ER)阴性细胞系中。然而,流行病学研究并未支持他汀类药物使用对乳腺癌的预防作用。因此,我们研究了他汀类药物的使用与乳腺癌患者对侧乳腺癌(CBC)风险之间的关系。

方法

我们从丹麦乳腺癌组数据库中确定了 52723 名在 1996 年至 2012 年间患有非转移性乳腺癌的女性。我们将诊断后时间变化的他汀类药物使用定义为至少两次处方,间隔 1 年。Cox 回归分析用于估计与他汀类药物使用相关的 CBC 的风险比(HR)和 95%置信区间(CI)。

结果

他汀类药物的使用与 CBC 风险降低相关(HR=0.88;95%CI=0.73-1.05)。总体而言,长期使用的反向关联最强(HR=0.64;95%CI=0.43-0.96),尽管长期一致使用和高强度使用的 HR 接近 1。在 ER 阴性乳腺癌患者中,他汀类药物的使用与 CBC 风险降低相关(HR=0.67;95%CI=0.45-1.00)。

结论

我们发现他汀类药物可能降低 CBC 风险的一些迹象。需要进一步评估以阐明长期使用的结果是否存在争议,并确定 ER 阴性乳腺癌患者是否最受益于他汀类药物的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be81/6251024/688eef375f08/41416_2018_252_Fig1_HTML.jpg

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