Kim Ji Eun, Kim Tae Jun, Lee Hyuk, Lee Yeong Chan, Chung Hwe Hoon, Min Yang Won, Min Byung-Hoon, Lee Jun Haeng, Kim Jae J
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
J Clin Med. 2021 Dec 30;11(1):193. doi: 10.3390/jcm11010193.
() eradication can prevent metachronous gastric cancer (MGC) after the performance of an endoscopic resection for early gastric cancer (EGC). However, 50% of infections persist after eradication, and the identification of MGC protective factors is important. The anti-tumor activity of aspirin has been demonstrated, but its efficacy in preventing MGC remains controversial. We evaluated the effect of aspirin on metachronous recurrence in -negative patients.
A total of 4351 patients were evaluated between January 2007 and December 2016, and 2151 patients who met the inclusion criteria were analyzed. The primary outcome was the cumulative incidence of MGC after an endoscopic resection for EGC.
During a 5-year median follow-up (interquartile range, 3.5-6.2), MGC developed in 176 (7.7%) patients, with a cumulative incidence of 89.4% in aspirin users and 92.7% in non-users; this difference was not statistically significant ( = 0.64). The duration of aspirin uses and the occurrence of MGC in both groups were not significantly different. There was no significant difference between groups when the duration of aspirin use was categorized into ≤1 year (hazard ratio (HR), 0.64; 0.20-2.01, = 0.45), 1-4 years (HR, 1.35; 0.66-2.76, = 0.41), and >4 years (HR, 1.17; 0.67-2.03, = 0.58).
Aspirin use was not associated with a lower risk of MGC in -negative patients. Further prospective studies are needed.
(幽门螺杆菌)根除可预防早期胃癌(EGC)内镜切除术后的异时性胃癌(MGC)。然而,根除后仍有50%的感染持续存在,因此识别MGC的保护因素很重要。阿司匹林的抗肿瘤活性已得到证实,但其预防MGC的疗效仍存在争议。我们评估了阿司匹林对幽门螺杆菌阴性患者异时性复发的影响。
2007年1月至2016年12月期间共评估了4351例患者,对符合纳入标准的2151例患者进行了分析。主要结局是EGC内镜切除术后MGC的累积发病率。
在中位随访5年期间(四分位间距,3.5 - 6.2年),176例(7.7%)患者发生了MGC,阿司匹林使用者的累积发病率为89.4%,非使用者为92.7%;差异无统计学意义(P = 0.64)。两组阿司匹林使用时间和MGC发生情况无显著差异。当将阿司匹林使用时间分为≤1年(风险比(HR),0.64;95%置信区间,0.20 - 2.01,P = 0.45)、1 - 4年(HR,1.35;95%置信区间,0.66 - 2.76,P = 0.41)和>4年(HR,1.17;95%置信区间,0.67 - 2.03,P = 0.58)时,组间无显著差异。
幽门螺杆菌阴性患者使用阿司匹林与较低的MGC风险无关。需要进一步的前瞻性研究。