Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden.
Sci Rep. 2021 Jun 29;11(1):13486. doi: 10.1038/s41598-021-92347-0.
The aim of this study was to explore the male predominance in esophageal and gastric adenocarcinoma by evaluating the preventive potential of androgen deprivation therapy (ADT). This matched cohort study was based on a national Swedish database of prostate cancer patients in 2006-2013. Prostate cancer patients receiving ADT were the exposed group. Prostate cancer-free men from the general population were randomly selected and matched to the index case by birth year and county of residence, forming the unexposed control group. The participants were followed until a diagnosis of esophageal or gastric cancer, death, emigration, or end of the study period. The risk of esophageal adenocarcinoma, cardia gastric adenocarcinoma, non-cardia gastric adenocarcinoma, and esophageal squamous-cell carcinoma among ADT-exposed compared to unexposed was calculated by multivariable Cox proportional hazard regression. The hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for confounders. There was a risk reduction of non-cardia gastric adenocarcinoma among ADT-users compared to non-users (HR 0.49 [95% CI 0.24-0.98]). No such decreased risk was found for esophageal adenocarcinoma (HR 1.17 [95% CI 0.60-2.32]), cardia gastric adenocarcinoma (HR 0.99 [95% CI 0.40-2.46]), or esophageal squamous cell carcinoma (HR 0.99 [95% CI 0.31-3.13]). This study indicates that androgen deprivation therapy decreases the risk of non-cardia gastric adenocarcinoma, while no decreased risk was found for esophageal adenocarcinoma, cardia gastric adenocarcinoma, or esophageal squamous-cell carcinoma.
本研究旨在通过评估雄激素剥夺疗法（ADT）的预防潜力，探讨食管和胃腺癌中男性优势的原因。该匹配队列研究基于 2006 年至 2013 年期间瑞典全国前列腺癌患者数据库。接受 ADT 的前列腺癌患者为暴露组。从一般人群中随机选择前列腺癌患者，并按出生年份和居住县与指数病例相匹配，形成未暴露对照组。随访至诊断为食管癌或胃癌、死亡、移民或研究结束。使用多变量 Cox 比例风险回归计算 ADT 暴露与未暴露相比，食管腺癌、贲门胃腺癌、非贲门胃腺癌和食管鳞状细胞癌的风险。调整混杂因素后，计算风险比（HR）和 95%置信区间（CI）。与未使用者相比，ADT 使用者中非贲门胃腺癌的风险降低（HR 0.49 [95%CI 0.24-0.98]）。对于食管腺癌（HR 1.17 [95%CI 0.60-2.32]）、贲门胃腺癌（HR 0.99 [95%CI 0.40-2.46]）或食管鳞状细胞癌（HR 0.99 [95%CI 0.31-3.13]），未发现这种风险降低。本研究表明，雄激素剥夺疗法降低了非贲门胃腺癌的风险，而食管腺癌、贲门胃腺癌或食管鳞状细胞癌的风险并未降低。
