Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.
State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China.
J Cancer Res Clin Oncol. 2021 Jan;147(1):139-151. doi: 10.1007/s00432-020-03394-5. Epub 2020 Sep 23.
We aimed to elucidate the associations between aspirin use with risk of lung cancer, by conducting a meta-analysis and Mendelian randomization (MR) analyses from published Genome-Wide Association Studies (GWAS).
Cohort studies, nested case-control studies, and randomized controlled trials (RCTs) investigating the impact of aspirin exposure and lung cancer incidence were included. Relative risk (RR) and its 95% confidence interval (CI) were evaluated in eligible studies. Subgroup analyses regarding gender, pathologic subtypes and smoking status were also executed. MR analyses were conducted using summary statistics obtained from two large consortia [Neale Lab and International Lung Cancer Consortium (ILCCO)] to assess the possible causal relationship of aspirin on lung cancer incidence.
Sixteen eligible studies involving 1,522,687 patients were included. The combined RR of aspirin use for the incidence of lung cancer was 0.95 (95% confidence interval (CI) 0.91-0.98). In subgroup meta-analyses, a significant protective effect was observed in squamous cell lung cancer (RR = 0.80; 95% CI 0.65-0.98). In terms of gender, the chemopreventive value was only observed among men (RR = 0.87; 95% CI 0.77-0.97). The MR risk analysis suggested a causal effect of aspirin on lung cancer incidence, with evidence of a decreased risk for overall lung cancer (OR = 0.042; 95% CI 0.003-0.564) and squamous cell lung cancer (OR = 0.002; 95% CI 1.21 × 10-0.301).
Our study provided evidence for a causal protective effect of aspirin on the risk of lung cancer incidence among men, particularly on the squamous cell lung cancer risk.
通过对已发表的全基因组关联研究（GWAS）进行荟萃分析和孟德尔随机化（MR）分析，阐明阿司匹林使用与肺癌风险之间的关联。
纳入了研究阿司匹林暴露与肺癌发病率影响的队列研究、巢式病例对照研究和随机对照试验（RCT）。评估了合格研究中的相对风险（RR）及其 95%置信区间（CI）。还进行了亚组分析，包括性别、病理亚型和吸烟状况。使用来自两个大型联盟[Neale 实验室和国际肺癌联盟（ILCCO）]的汇总统计数据进行 MR 分析，以评估阿司匹林对肺癌发病率的可能因果关系。
纳入了 1522687 名患者的 16 项合格研究。阿司匹林使用与肺癌发生率的合并 RR 为 0.95（95%CI 0.91-0.98）。在亚组荟萃分析中，在鳞状细胞肺癌中观察到了显著的保护作用（RR=0.80；95%CI 0.65-0.98）。就性别而言，仅在男性中观察到了化学预防作用（RR=0.87；95%CI 0.77-0.97）。MR 风险分析表明阿司匹林对肺癌发病率有因果影响，表明整体肺癌（OR=0.042；95%CI 0.003-0.564）和鳞状细胞肺癌（OR=0.002；95%CI 1.21×10-0.301）的风险降低。
我们的研究为阿司匹林对男性肺癌发病率的因果保护作用提供了证据，特别是对鳞状细胞肺癌的风险。
