阿司匹林对前列腺癌患者发病、复发和死亡的影响：整合随机对照试验和真实世界研究的证据。

Effect of aspirin on incidence, recurrence, and mortality in prostate cancer patients: integrating evidence from randomized controlled trials and real-world studies.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.

Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230032, Anhui, China.

出版信息

Eur J Clin Pharmacol. 2023 Nov;79(11):1475-1503. doi: 10.1007/s00228-023-03556-7. Epub 2023 Aug 30.

DOI:10.1007/s00228-023-03556-7

PMID:37648741

Abstract

PURPOSE

Aspirin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between aspirin use and the risk of occurrence of prostate cancer (PCa). The purpose of this study was to assess the effect of aspirin on clinical outcomes in patients with PCa in a meta-analysis and to explore the possible dose-response relationship.

METHODS

A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined relative risks (RRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of aspirin on the risk of PCa. Relevant subgroup analyses and sensitivity analyses were performed.

RESULTS

The across studies results show that aspirin use associated with lower incidence of PCa (RR: 0.96, 95% CI: 0.95-0.98), and reduced mortality (RR: 0.88, 95% CI: 0.82-0.95). The results of the subgroup analysis indicated that both cohort and population studies in the Americas showed a reduction in PCa incidence and mortality with aspirin use. A linear correlation was observed between dosage/duration of aspirin use and its protective effect. Additionally, post-diagnosis aspirin use was associated with decreased risk of PCa mortality.

CONCLUSIONS

This meta-analysis revealed an independent correlation between the use of aspirin and reductions in both the incidence and mortality rates of PCa. However, randomized controlled trials did not find any association between aspirin use and PCa. Furthermore, the impact of aspirin on PCa occurrence was found to be dependent on both dosage and duration.

摘要

目的

已有研究提示阿司匹林可能降低癌症风险。然而，既往研究中阿司匹林的使用与前列腺癌（PCa）发生风险之间的关系并不一致。本研究旨在通过荟萃分析评估阿司匹林对 PCa 患者临床结局的影响，并探讨可能的剂量-反应关系。

方法

通过 10 个电子数据库和 4 个注册处进行系统文献检索。采用随机效应模型计算合并相对风险（RR）及其 95%置信区间（CI）以评估阿司匹林对 PCa 风险的影响。进行了相关亚组分析和敏感性分析。

结果

各研究结果显示，阿司匹林的使用与 PCa 发生率降低相关（RR：0.96，95%CI：0.95-0.98），死亡率降低（RR：0.88，95%CI：0.82-0.95）。亚组分析结果表明，在美洲进行的队列研究和人群研究均显示阿司匹林的使用可降低 PCa 的发生率和死亡率。阿司匹林使用剂量/时间与保护作用之间存在线性相关性。此外，诊断后阿司匹林的使用与降低 PCa 死亡率的风险相关。