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血管紧张素 II 受体阻滞剂和口腔鳞状细胞癌生存:倾向评分匹配队列研究。

Angiotensin II receptor blockers and oral squamous cell carcinoma survival: A propensity-score-matched cohort study.

机构信息

Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

PLoS One. 2021 Dec 2;16(12):e0260772. doi: 10.1371/journal.pone.0260772. eCollection 2021.

Abstract

OBJECTIVES

Angiotensin II receptor blockers (ARBs) improve the survival rates of patients with various cancers. However, it remains unclear whether ARBs confer a survival benefit on patients with oral squamous cell carcinoma (OSCC). Here, we assessed the associations between ARB use and survival in patients with OSCC of different stages.

MATERIALS AND METHODS

This was a 10-year retrospective cohort study of OSCC patients. We enrolled 7,558 patients diagnosed with oral cancer between January 2007 and December 2017 whose details had been entered into the Chang Gung Research Database. Seven hundred and fourteen patients were recruited from the Chang Gung Research Database after performing 1:1 propensity score-matching between ARB users and non-users. Cox's regression models with adjusted covariates were employed to detect factors influencing the survival rates of patients with OSCC.

RESULTS

Kaplan-Meier analysis revealed that the overall survival (OS) rate of 180-day ARB users increased (p = 0.038). Cox's regression models indicated that ARB use, younger patients, early-stage OSCC, and patients without diabetes mellitus were independently prognostic of improved OS. Increased OS was more prominent in 180-day ARB users in stage III, Iva, and IVb categories.

CONCLUSIONS

ARB use for more than 180 days is associated with an increased survival rate and is a positive, independent prognostic factor in patients with OSCC. A further two-arm study should be conducted to confirm the clinical usefulness of ARBs in OSCC patients.

摘要

目的

血管紧张素 II 受体阻滞剂(ARBs)可提高多种癌症患者的生存率。然而,ARBs 是否能使口腔鳞状细胞癌(OSCC)患者获益仍不清楚。本研究评估了 ARB 应用与不同分期 OSCC 患者生存的相关性。

材料与方法

这是一项回顾性队列研究,纳入了 2007 年 1 月至 2017 年 12 月期间录入长庚研究数据库的 7558 例口腔癌患者,对 ARB 使用者和非使用者进行 1:1 倾向评分匹配,共纳入 714 例患者。采用 Cox 回归模型分析调整混杂因素后,检测影响 OSCC 患者生存率的因素。

结果

Kaplan-Meier 分析显示,180 天 ARB 使用者的总生存率(OS)提高(p = 0.038)。Cox 回归模型表明,ARB 应用、年轻患者、早期 OSCC 以及无糖尿病患者是 OS 改善的独立预后因素。在 III 期、Iva 期和 IVb 期患者中,180 天 ARB 使用者的 OS 改善更为显著。

结论

ARBs 应用超过 180 天与生存率的提高相关,是 OSCC 患者的一个积极独立的预后因素。应开展进一步的双盲研究以确认 ARBs 在 OSCC 患者中的临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3a5/8638984/eb5d534e8393/pone.0260772.g001.jpg

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