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芬兰卵巢癌患者中抗高血压药物的使用与卵巢癌死亡风险——一项全国性队列研究

Antihypertensive Drug Use and the Risk of Ovarian Cancer Death among Finnish Ovarian Cancer Patients-A Nationwide Cohort Study.

作者信息

Santala Eerik E E, Artama Miia, Pukkala Eero, Visvanathan Kala, Staff Synnöve, Murtola Teemu J

机构信息

Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland.

Finnish Institute for Health and Welfare, 33520 Tampere, Finland.

出版信息

Cancers (Basel). 2021 Apr 26;13(9):2087. doi: 10.3390/cancers13092087.

Abstract

Ovarian cancer (OC) has a poor prognosis. Hypertension may be a prognostic factor for OC, but it is unclear whether antihypertensive (anti-HT) drug use of modifies OC prognosis. We performed a population-based analysis assessing the effect of anti-HT drug use on OC mortality. A cohort of 12,122 women identified from the Finnish Cancer Registry with OC in 1995-2013 was combined with information on their anti-HT drug use during the same time period. Use of each anti-HT drug was analysed as a time-dependent variable. Analyses were run for five, ten and full follow-up (19-year) mortality with cardiovascular morbidity risk evaluated in competing risk analysis. No anti-HT drug group was associated with OC survival within five years after OC diagnosis. At ten years, a dose-dependent association was observed between pre-diagnostic ACE-inhibitor use and improved OC survival. With full follow-up, post-diagnostic high-intensity use associated with reduced OC death risk for multiple anti-HT drug groups. In competing risk analysis, only the post-diagnostic use of ACE-inhibitors associated with increased OC survival. Anti-HT drugs were not associated with survival benefits within five years after OC diagnosis. ACE-inhibitors may confer survival benefits in women with OC, but further confirmatory studies are needed.

摘要

卵巢癌(OC)预后较差。高血压可能是OC的一个预后因素,但尚不清楚使用抗高血压(抗-HT)药物是否会改变OC的预后。我们进行了一项基于人群的分析,评估抗-HT药物使用对OC死亡率的影响。从芬兰癌症登记处识别出的1995年至2013年患有OC的12122名女性队列与同一时期她们使用抗-HT药物的信息相结合。每种抗-HT药物的使用作为一个时间依赖性变量进行分析。对5年、10年和全随访期(19年)死亡率进行分析,并在竞争风险分析中评估心血管发病风险。在OC诊断后的五年内,没有抗-HT药物组与OC生存率相关。在10年时,观察到诊断前使用血管紧张素转换酶抑制剂(ACEI)与OC生存率提高之间存在剂量依赖性关联。在全随访期,多个抗-HT药物组的诊断后高强度使用与OC死亡风险降低相关。在竞争风险分析中,只有诊断后使用ACEI与OC生存率提高相关。在OC诊断后的五年内,抗-HT药物与生存获益无关。ACEI可能会给OC女性带来生存获益,但需要进一步的验证性研究。

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