Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, China.
Nursing Department, First People's Hospital of Suzhou, Anhui, China.
Clin Breast Cancer. 2021 Dec;21(6):552-565. doi: 10.1016/j.clbc.2021.02.005. Epub 2021 Feb 17.
Some evidence shows that aspirin can reduce the morbidity and mortality of different cancers, including breast cancer. Aspirin has become a new focus of cancer prevention and treatment research at present, however, clinical studies found conflicting conclusions of its anticancer characteristics.
A systematic literature search was performed in 8 electronic databases. The pooled relative risk (RR) with 95% confidence interval (CI) was calculated using the random effects model to estimate the effect of aspirin on breast cancer.
Forty-two published articles with 99,769 patients were identified. The meta-analysis showed a significant decrease in breast cancer risk with aspirin use (RR, 0.92; 95% CI, 0.89-0.96; I = 72%). Aspirin use decreased the risk of hormone receptor-positive tumors (estrogen receptor [ER]-positive RR, 0.89; 95% CI, 0.82-0.97; I=54%; progesterone receptor [PR]-positive RR, 0.86; 95% CI, 0.78-0.95; I=32%; ER- and PR-positive RR, 0.92; 95% CI, 0.85-1.00; I=45%) and reduced the risk of breast cancer in postmenopausal women (RR, 0.92; 95% CI, 0.86-0.98; I=59%). Further analysis showed that for the in situ breast cancer, regular-dose and more than 3 years use of aspirin were associated with the reduced risk of breast cancer.
This meta-analysis suggested that aspirin may reduce the overall risk of breast cancer, reduce the risk of breast cancer in postmenopausal women, hormone receptor-positive tumors, and in situ breast cancer. Larger, multicenter clinical studies are needed to find the optimal dose range, frequency, and duration of the aspirin use to explore the best benefit-risk ratio.
有证据表明,阿司匹林可以降低包括乳腺癌在内的多种癌症的发病率和死亡率。目前,阿司匹林已成为癌症防治研究的新焦点,但临床研究得出的其抗癌特性结论却相互矛盾。
系统检索了 8 个电子数据库中的文献。采用随机效应模型计算合并相对风险(RR)及其 95%置信区间(CI),以评估阿司匹林对乳腺癌的影响。
共纳入 42 篇已发表的文章,涉及 99769 例患者。荟萃分析显示,阿司匹林的使用降低了乳腺癌的发病风险(RR,0.92;95%CI,0.89-0.96;I²=72%)。阿司匹林的使用降低了激素受体阳性肿瘤的发病风险(雌激素受体 [ER] 阳性 RR,0.89;95%CI,0.82-0.97;I=54%;孕激素受体 [PR] 阳性 RR,0.86;95%CI,0.78-0.95;I=32%;ER 和 PR 阳性 RR,0.92;95%CI,0.85-1.00;I=45%),且降低了绝经后妇女乳腺癌的发病风险(RR,0.92;95%CI,0.86-0.98;I=59%)。进一步分析显示,对于原位乳腺癌,规律剂量和使用超过 3 年与乳腺癌发病风险降低相关。
该荟萃分析提示,阿司匹林可能降低乳腺癌的总体发病风险,降低绝经后妇女、激素受体阳性肿瘤和原位乳腺癌的发病风险。需要更大规模、多中心的临床研究来确定阿司匹林的最佳剂量范围、使用频率和时长,以探索最佳的获益-风险比。