2 型糖尿病女性的抗糖尿病药物和他汀类药物与导管内和小叶乳腺癌生存的关系。

Association of antidiabetic medication and statins with survival from ductal and lobular breast carcinoma in women with type 2 diabetes.

机构信息

Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 22, 90029, Oulu, Finland.

Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 23, 90029, Oulu, Finland.

出版信息

Sci Rep. 2021 May 17;11(1):10445. doi: 10.1038/s41598-021-88488-x.

Abstract

We investigated the survival of female patients with pre-existing type 2 diabetes (T2D) diagnosed with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of breast, in relation to the use of metformin, other antidiabetic medication (ADM) and statins. The study cohort consisted of 3,165 women (2,604 with IDC and 561 with ILC). The cumulative mortality from breast cancer (BC) and from other causes was calculated using the Aalen-Johansen estimator. The cause-specific mortality rates were analysed by Cox models, and adjusted hazard ratios (HRs) were estimated for the use of different medications. No evidence of an association of metformin use with BC mortality was observed in either IDC (HR 0.92, 95% confidence interval [CI] 0.64-1.31) or ILC (HR 0.68, 95% CI 0.32-1.46) patients, when compared to other oral ADMs. The mortality from other causes was found to be lower amongst the IDC patients using metformin (HR 0.64, 95% CI 0.45-0.89), but amongst ILC patients the evidence was inconclusive (HR 1.22, 95% CI 0.64-2.32). Statin use was consistently associated with reduced mortality from BC in IDC patients (HR 0.77, 95% CI 0.62-0.96) and ILC patients (HR 0.59, 95% CI 0.37-0.96), and also mortality from other causes in IDC patients (HR 0.81, 95% CI 0.67-0.96) and in ILC patients (HR 0.66, 95% CI 0.43-1.01). We found no sufficient evidence for the possible effects of metformin and statins on the prognosis of BC being different in the two histological subtypes.

摘要

我们研究了患有浸润性导管癌(IDC)和浸润性小叶癌(ILC)的女性患者,在使用二甲双胍、其他降糖药物(ADM)和他汀类药物的情况下,其生存情况与 2 型糖尿病(T2D)的关系。该研究队列包括 3165 名女性(2604 名 IDC 和 561 名 ILC)。使用 Aalen-Johansen 估计器计算乳腺癌(BC)和其他原因的累积死亡率。使用 Cox 模型分析特定原因的死亡率,并为使用不同药物估计调整后的危险比(HR)。在 IDC 患者(HR 0.92,95%置信区间 [CI] 0.64-1.31)或 ILC 患者(HR 0.68,95% CI 0.32-1.46)中,未观察到二甲双胍使用与 BC 死亡率相关的证据,与其他口服 ADM 相比。IDC 患者使用二甲双胍时,其他原因导致的死亡率较低(HR 0.64,95%CI 0.45-0.89),但 ILC 患者的证据尚无定论(HR 1.22,95%CI 0.64-2.32)。他汀类药物的使用与 IDC 患者的 BC 死亡率降低(HR 0.77,95%CI 0.62-0.96)和 ILC 患者的 BC 死亡率降低(HR 0.59,95%CI 0.37-0.96)以及 IDC 患者的其他原因死亡率降低(HR 0.81,95%CI 0.67-0.96)和 ILC 患者的其他原因死亡率降低(HR 0.66,95%CI 0.43-1.01)。我们没有发现足够的证据表明二甲双胍和他汀类药物对两种组织学亚型的 BC 预后的影响有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3558/8129135/98eefdee33f9/41598_2021_88488_Fig1_HTML.jpg

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