Lacroix Olivia, Couttenier Alexandra, Vaes Evelien, Cardwell Chris R, De Schutter Harlinde, Robert Annie
Pôle d'Épidémiologie et Biostatistique, Université Catholique de Louvain (UCL), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-champs, 30 bte B1.30.13, 1200, Brussels, Belgium.
Research Department, Belgian Cancer Registry, Rue Royale 215, 1210, Brussels, Belgium.
Cancer Causes Control. 2019 Apr;30(4):385-393. doi: 10.1007/s10552-019-01149-3. Epub 2019 Feb 28.
Preclinical studies have shown that statins reduce proliferation in esophageal cancer. Three recent observational studies have shown encouraging results but suffered from limitations. This work aimed to assess at the Belgian population level whether statin usage was associated with a decreased mortality in esophageal cancer patients.
We conducted an observational, population-based study by linking data of the Belgian Cancer Registry (BCR) with medical claims data coming from health insurance companies and mortality records collected by regional governments for patients diagnosed with esophageal cancer between 2004 and 2014. Using time-dependent Cox regression models, hazard ratios (HRs) and 95% confidence intervals (CI) for overall and cancer-specific mortality were calculated.
Of 6,238 patients with stage I-III esophageal cancer, post-diagnostic use of statins was found in 1,628 (26%) patients. Statins use after diagnosis was associated with a reduction in overall mortality (adjusted HR = 0.84, 95% CI [0.77; 0.92]) and cancer-specific mortality (adjusted HR = 0.87, 95% CI [0.78; 0.97]). Similar association were also seen for pre-diagnostic statin use in overall (adjusted HR = 0.83, 95% CI [0.76-0.91]) and cancer-specific analysis (adjusted HR = 0.86, 95% CI [0.77-0.96]).
In this large cohort of Belgian patients with esophageal cancer, statins use after diagnosis was associated with a decreased mortality.
临床前研究表明，他汀类药物可降低食管癌的增殖。最近的三项观察性研究显示了令人鼓舞的结果，但存在局限性。这项研究旨在评估在比利时人群层面，他汀类药物的使用是否与食管癌患者死亡率降低相关。
我们通过将比利时癌症登记处（BCR）的数据与来自健康保险公司的医疗理赔数据以及地区政府收集的2004年至2014年期间诊断为食管癌患者的死亡率记录相链接，进行了一项基于人群的观察性研究。使用时间依赖性Cox回归模型，计算了总体死亡率和癌症特异性死亡率的风险比（HR）和95%置信区间（CI）。
在6238例I-III期食管癌患者中，1628例（26%）患者在诊断后使用了他汀类药物。诊断后使用他汀类药物与总体死亡率降低相关（调整后HR = 0.84，95% CI [0.77; 0.92]）以及癌症特异性死亡率降低相关（调整后HR = 0.87，95% CI [0.78; 0.97]）。在总体（调整后HR = 0.83，95% CI [0.76 - 0.91]）和癌症特异性分析（调整后HR = 0.86，95% CI [0.77 - 0.96]）中，诊断前使用他汀类药物也观察到类似的关联。
在这个大型比利时食管癌患者队列中，诊断后使用他汀类药物与死亡率降低相关。
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