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钙通道阻滞剂的使用与术后女性乳腺癌复发之间的保护关联:台湾一项基于人群的病例对照研究

Protective Association Between Calcium Channel Blocker Use and Breast Cancer Recurrence in Postsurgical Women: A Population-Based Case-Control Study in Taiwan.

作者信息

Shih Jui-Hu, Kao Li-Ting, Chung Chi-Hsiang, Liao Guo-Shiou, Fann Li-Yun, Chien Wu-Chien, Li I-Hsun

机构信息

Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan.

School of Pharmacy, National Defense Medical Center, Taipei, Taiwan.

出版信息

J Clin Pharmacol. 2020 Jun;60(6):785-792. doi: 10.1002/jcph.1579. Epub 2020 Feb 5.

Abstract

Neoadjuvant chemotherapy induces metastasis of residual breast cancers through activation of tumor-associated macrophages. Previous studies have indicated that calcium channel blockers (CCBs) exert anti-inflammatory and antimigratory effects on macrophages via attenuating Ca entry into macrophages. However, no existing empirical research has addressed the relationship between previous CCB use and breast cancer recurrence. In this study, 4840 Taiwanese women aged ≥20 years with breast cancer who underwent breast surgery from January 1, 2007, to December 31, 2015, were enrolled. The date of cancer recurrence was defined as the index date. Logistic regression was performed to evaluate the relationship between previous CCB exposure and cancer recurrence among female patients who underwent surgery for breast cancer. After adjusting for demographic characteristics, comorbidities, and tumor-node-metastasis stage, the adjusted odds ratio (OR) for CCB exposure within 5 years before the index date in women with recurrence compared with nonrecurrent controls was 0.73 (95% confidence interval [CI], 0.53-0.97). Further analysis revealed that the adjusted OR for CCB exposure between the surgery and index dates in women with recurrence relative to nonrecurrent controls was 0.72 (95%CI, 0.66-0.95). In particular, prior CCB use was significantly associated with a lower risk (34%) of breast cancer recurrence among women 20 to 54 years old (OR, 0.66; 95%CI, 0.47-0.83). This study uncovered a protective association between previous CCB use and breast cancer recurrence.

摘要

新辅助化疗通过激活肿瘤相关巨噬细胞诱导残留乳腺癌转移。先前的研究表明,钙通道阻滞剂(CCB)通过减少钙离子进入巨噬细胞,对巨噬细胞发挥抗炎和抗迁移作用。然而,目前尚无实证研究探讨既往使用CCB与乳腺癌复发之间的关系。本研究纳入了2007年1月1日至2015年12月31日期间在台湾接受乳腺癌手术的4840名年龄≥20岁的女性。将癌症复发日期定义为索引日期。采用逻辑回归分析评估接受乳腺癌手术的女性患者既往CCB暴露与癌症复发之间的关系。在调整人口统计学特征、合并症和肿瘤-淋巴结-转移分期后,复发女性在索引日期前5年内CCB暴露的调整优势比(OR)为0.73(95%置信区间[CI],0.53-0.97),与未复发对照组相比。进一步分析显示,复发女性在手术日期与索引日期之间CCB暴露的调整OR为0.72(95%CI,0.66-0.95),相对于未复发对照组。特别是,在20至54岁的女性中,既往使用CCB与乳腺癌复发风险降低(34%)显著相关(OR,0.66;95%CI,0.47-0.83)。本研究发现既往使用CCB与乳腺癌复发之间存在保护性关联。

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