Kwon Tae Jin, Kim Tae Jun, Lee Hyuk, Min Yang Won, Min Byung-Hoon, Lee Jun Haeng, Kim Jae J
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.
Cancers (Basel). 2021 Mar 1;13(5):1020. doi: 10.3390/cancers13051020.
Previous studies have shown that statins reduce the risk of gastric cancer; however, their role has not been adequately studied in patients without infection. We aimed to investigate whether statins reduced the risk of metachronous gastric cancer (GC) in -negative patients who underwent endoscopic resection for early gastric cancer (EGC). Retrospective data of 2153 patients recruited between January 2007 and December 2016, with no infection at baseline, who underwent resection for EGC, were analyzed. Metachronous GC was defined as a newly developed GC at least 1 year after endoscopic resection. Patients who used statins for at least 28 days during the follow-up period were considered as statin users. During a median follow-up of 5 years (interquartile range, 3.5-6.2), metachronous GC developed in 165 (7.6%) patients. In the multivariate Cox regression analysis, statin use was an independent factor associated with GC recurrence (adjusted hazard ratio (HR), 0.46; 95% confidence interval (CI), 0.26-0.82). Moreover, the risk of GC reduced with increasing duration (<3 years: HR 0.40, 95% CI 0.14-1.13; ≥3 years: HR 0.21, 95% CI 0.05-0.90; trend = 0.011) and the dose of statin (cumulative defined daily dose (cDDD) < 500: HR 0.45, 95% CI 0.16-1.28; cDDD ≥ 500: HR 0.19, 95% CI 0.04-0.80; trend = 0.008) in the propensity score-matched cohort. Statin use was associated with a lower risk of GC recurrence in -negative patients with resected EGC in a dose-response relationship.
既往研究表明，他汀类药物可降低胃癌风险；然而，其在未感染患者中的作用尚未得到充分研究。我们旨在调查他汀类药物是否能降低接受早期胃癌（EGC）内镜切除的幽门螺杆菌阴性患者发生异时性胃癌（GC）的风险。分析了2007年1月至2016年12月期间招募的2153例基线时无幽门螺杆菌感染、接受EGC切除的患者的回顾性数据。异时性GC定义为内镜切除后至少1年新发生的GC。在随访期间使用他汀类药物至少28天的患者被视为他汀类药物使用者。在中位随访5年（四分位间距，3.5 - 6.2年）期间，165例（7.6%）患者发生了异时性GC。在多变量Cox回归分析中，使用他汀类药物是与GC复发相关的独立因素（调整后的风险比（HR）为0.46；95%置信区间（CI）为0.26 - 0.82）。此外，在倾向评分匹配队列中，GC风险随着他汀类药物使用时间的延长（<3年：HR 0.40，95% CI 0.14 - 1.13；≥3年：HR 0.21，95% CI 0.05 - 0.90；P趋势 = 0.011）和剂量的增加而降低（累积限定日剂量（cDDD）<500：HR 0.45，95% CI 0.16 - 1.28；cDDD≥500：HR 0.19，95% CI 0.04 - 0.80；P趋势 = 0.008）。在接受EGC切除的幽门螺杆菌阴性患者中，使用他汀类药物与较低的GC复发风险呈剂量反应关系。
