Wu Chin-Chia, Fang Chuan-Yin, Yu Ben-Hui, Chang Chun-Ming, Hsu Ta-Wen, Hung Chung-Lin, Hung Shih-Kai, Chiou Wen-Yen, Tsai Jui-Hsiu
Division of Colorectal Surgery, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan.
School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970374, Taiwan.
Cancers (Basel). 2023 Nov 6;15(21):5304. doi: 10.3390/cancers15215304.
The dose-response effect of proton pump inhibitors on colorectal cancer prognosis is still under exploration. This population-based study in Taiwan was designed to examine the effect of proton pump inhibitors on overall death, colorectal cancer-specific death, and recurrence in colorectal cancer patients with different cumulative proton pump inhibitor dose levels. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2005 to 2020. After frequency matching with a 1:1 ratio, a total of 20,889 users with proton pump inhibitors and 20,889 without proton pump inhibitors were analyzed. The cumulative defined daily dose level of proton pump inhibitor was stratified to explore the dose-response relationship. A proton pump inhibitor exposure cumulative defined daily dose > 60 after colorectal cancer diagnosis had higher risk of all-cause death than non-proton pump inhibitor users with adjusted hazard ratios of 1.10 (95% CIs: 1.04-1.18). For recurrence, a proton pump inhibitor exposure cumulative defined daily dose > 60 had reduced recurrence risk with an adjusted hazard ratio of 0.84 (95% CIs: 0.76-0.93). This study demonstrated that the long-term use of proton pump inhibitors in patients with colorectal cancer was associated with an increased risk of death that related to the proton pump inhibitor exposure cumulative defined daily dose > 60 and had different dose-response effect in various dose level.
质子泵抑制剂对结直肠癌预后的剂量反应效应仍在探索中。这项在台湾开展的基于人群的研究旨在探讨质子泵抑制剂对不同累积质子泵抑制剂剂量水平的结直肠癌患者全因死亡、结直肠癌特异性死亡及复发的影响。这项队列研究基于2005年至2020年的台湾癌症登记处和台湾国民健康保险研究数据库。经过1:1比例的频率匹配后，共分析了20,889名使用质子泵抑制剂的用户和20,889名未使用质子泵抑制剂的用户。对质子泵抑制剂的累积限定日剂量水平进行分层，以探索剂量反应关系。结直肠癌诊断后质子泵抑制剂暴露累积限定日剂量>60的患者全因死亡风险高于未使用质子泵抑制剂的患者，调整后的风险比为1.10（95%置信区间：1.04-1.18）。对于复发，质子泵抑制剂暴露累积限定日剂量>60的患者复发风险降低，调整后的风险比为0.84（95%置信区间：0.76-0.93）。这项研究表明，结直肠癌患者长期使用质子泵抑制剂与死亡风险增加相关，这与质子泵抑制剂暴露累积限定日剂量>60有关，并且在不同剂量水平具有不同的剂量反应效应。
