Getz Kayla R, Bellile Emily, Zarins Katie R, Rullman Cailey, Chinn Steven B, Taylor Jeremy M G, Rozek Laura S, Wolf Gregory T, Mondul Alison M
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Int J Cancer. 2021 May 15;148(10):2440-2448. doi: 10.1002/ijc.33441. Epub 2020 Dec 27.
Head and neck squamous cell carcinoma (HNSCC) is a morbid cancer with poor outcomes. Statins possess anticancer properties such as immunomodulatory and anti-inflammatory effects. The objective of our study is to identify the association between statin use among untreated HNSCC patients and overall death, disease-specific death and recurrence. HNSCC patients were recruited to participate in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE) from 2003 to 2014. Statin use data were collected through medical record review. Participants were considered a statin user if they used a statin at or after diagnosis. Outcome data were collected through medical record review, Social Security Death Index or LexisNexis. Our analytic cohort included 1638 participants. Cox proportional hazard models were used to estimate the association between ever statin use and HNSCC outcomes. Statin use was seen in 36.0% of participants. We observed a statistically significant inverse association between ever using a statin and overall death (HR = 0.75, 95% CI = 0.63-0.88) and HNSCC-specific death (HR = 0.79, 95% CI = 0.63-0.99) and a nonstatistically significant inverse association for recurrence (HR = 0.85, 95% CI = 0.70-1.04). When investigating the association between statin use and HNSCC outcomes utilizing interaction terms between statin use and human papillomavirus (HPV), statistically significant interactions for HNSCC-specific death and recurrence were identified (HNSCC-specific death: HPV-positive HR = 0.41, 95% CI = 0.21-0.84; HPV-negative HR = 1.04, 95% CI = 0.71-1.51; p-int=0.02; recurrence: HPV-positive HR = 0.49, 95% CI = 0.29-0.84; HPV-negative HR = 1.03, 95% CI = 0.74-1.43; p=int-0.02). Statin use may be protective for adverse outcomes in HNSCC patients, particularly those with HPV-positive disease. If true, these findings could have a meaningful impact on tertiary prevention for this cancer.
头颈部鳞状细胞癌（HNSCC）是一种预后不良的恶性肿瘤。他汀类药物具有免疫调节和抗炎等抗癌特性。我们研究的目的是确定未经治疗的HNSCC患者使用他汀类药物与全因死亡、疾病特异性死亡和复发之间的关联。2003年至2014年，招募HNSCC患者参与密歇根大学头颈部癌症卓越研究专项计划（SPORE）。通过病历审查收集他汀类药物使用数据。如果参与者在诊断时或诊断后使用他汀类药物，则被视为他汀类药物使用者。通过病历审查、社会保障死亡指数或LexisNexis收集结局数据。我们的分析队列包括1638名参与者。采用Cox比例风险模型来估计曾经使用他汀类药物与HNSCC结局之间的关联。36.0%的参与者使用过他汀类药物。我们观察到曾经使用他汀类药物与全因死亡（HR = 0.75，95%CI = 0.63 - 0.88）和HNSCC特异性死亡（HR = 0.79，95%CI = 0.63 - 0.99）之间存在统计学显著的负相关，而与复发之间存在非统计学显著的负相关（HR = 0.85，95%CI = 0.70 - 1.04）。在利用他汀类药物使用与人类乳头瘤病毒（HPV）之间的交互项研究他汀类药物使用与HNSCC结局之间的关联时，发现了HNSCC特异性死亡和复发的统计学显著交互作用（HNSCC特异性死亡：HPV阳性HR = 0.41，95%CI = 0.21 - 0.84；HPV阴性HR = 1.04，95%CI = 0.71 - 1.51；p值交互 = 0.02；复发：HPV阳性HR = 0.49，95%CI = 0.29 - 0.84；HPV阴性HR = 1.03，95%CI = 0.74 - 1.43；p值交互 = 0.02）。他汀类药物的使用可能对HNSCC患者的不良结局具有保护作用；特别是对于HPV阳性疾病的患者。如果属实，这些发现可能会对该癌症的三级预防产生重大影响。
