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抗炎药物与癌症之间的因果关系:一项孟德尔随机化的全癌研究

Causal relationship between anti-inflammatory drugs and cancer: a pan-cancer study with Mendelian randomization.

作者信息

Gao Shen, Wei Guojiang, Ma Qianwang, Wang Xue, Wang Sen, Niu Yuanjie

机构信息

Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.

Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.

出版信息

Front Genet. 2024 May 24;15:1392745. doi: 10.3389/fgene.2024.1392745. eCollection 2024.


DOI:10.3389/fgene.2024.1392745
PMID:38854429
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11156997/
Abstract

BACKGROUND: Numerous epidemiological studies have elucidated the intricate connection between inflammation and cancer, highlighting how sustained inflammatory responses can fuel carcinogenesis by fostering proliferation, angiogenesis, and metastasis, while dampening immune responses and sensitivity to chemotherapy. Previous clinical investigations have underscored the potential of anti-inflammatory medications in either preventing or mitigating tumor formation. Here, the causal relationship between anti-inflammatory drugs and cancer was further explored through Mendelian randomization studies. METHODS: Employing Mendelian randomization, we scrutinized the causal links between three anti-inflammatory drugs-NSAIDs, Aspirin, and Anilide-and 37 types of cancer. We primarily utilized inverse variance weighting (IVW) as the primary analytical approach to delineate the causal association between these drugs and cancer types. Concurrently, sensitivity analyses were conducted to ascertain the absence of horizontal pleiotropy and heterogeneity. RESULTS: Our investigation revealed a discernible causal relationship between certain anti-inflammatory drugs and a subset of cancers, albeit without a pervasive impact across all cancer types. Specifically, NSAIDs exhibited a risk-reducing effect on non-small cell lung cancer (OR: 0.76, 95% CI: 0.59-0.97, -value: 0.03) and gastric cancer (OR: 0.57, 95% CI: 0.34-0.98, -value: 0.04). Conversely, aspirin was associated with an increased risk of oral malignant tumors (OR: 2.18, 95% CI: 1.13-4.21, -value: 0.02). Notably, no statistically significant findings were observed for anilide drugs ( < 0.05). CONCLUSION: We identified several cancers with potential causal links to NSAIDs, including non-small cell lung cancer and gastric cancer. Despite our extensive analysis, we did not identify a substantial causal relationship between the use of anti-inflammatory drugs and the development of various cancers.

摘要

背景:众多流行病学研究阐明了炎症与癌症之间的复杂联系,强调了持续的炎症反应如何通过促进增殖、血管生成和转移来推动致癌作用,同时抑制免疫反应和化疗敏感性。先前的临床研究强调了抗炎药物在预防或减轻肿瘤形成方面的潜力。在此,通过孟德尔随机化研究进一步探讨了抗炎药物与癌症之间的因果关系。 方法:采用孟德尔随机化方法,我们研究了三种抗炎药物(非甾体抗炎药、阿司匹林和酰苯胺)与37种癌症之间的因果联系。我们主要采用逆方差加权法(IVW)作为主要分析方法来描述这些药物与癌症类型之间的因果关联。同时,进行敏感性分析以确定不存在水平多效性和异质性。 结果:我们的研究揭示了某些抗炎药物与一部分癌症之间存在明显的因果关系,尽管并非对所有癌症类型都有普遍影响。具体而言,非甾体抗炎药对非小细胞肺癌(OR:0.76,95%CI:0.59 - 0.97,P值:0.03)和胃癌(OR:0.57,95%CI:0.34 - 0.98,P值:0.04)具有降低风险的作用。相反,阿司匹林与口腔恶性肿瘤风险增加相关(OR:2.18,95%CI:1.13 - 4.21,P值:0.02)。值得注意的是,酰苯胺类药物未观察到具有统计学意义的结果(P < 0.05)。 结论:我们确定了几种与非甾体抗炎药可能存在因果联系的癌症,包括非小细胞肺癌和胃癌。尽管我们进行了广泛分析,但未发现抗炎药物的使用与各种癌症的发生之间存在实质性因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/d18e9ca8c11a/fgene-15-1392745-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/d581f25210a2/fgene-15-1392745-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/97ce02e745c8/fgene-15-1392745-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/74acd73ed8c2/fgene-15-1392745-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/5ff62a01f0ed/fgene-15-1392745-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/d18e9ca8c11a/fgene-15-1392745-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/d581f25210a2/fgene-15-1392745-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/97ce02e745c8/fgene-15-1392745-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/74acd73ed8c2/fgene-15-1392745-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/5ff62a01f0ed/fgene-15-1392745-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad49/11156997/d18e9ca8c11a/fgene-15-1392745-g005.jpg

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引用本文的文献

[1]
Genetically proxied risk and protective factors for pancreatic cancer: a systematic review and meta-analysis of Mendelian randomization studies.

J Gastrointest Oncol. 2025-6-30

[2]
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本文引用的文献

[1]
Perspectives of the Application of Non-Steroidal Anti-Inflammatory Drugs in Cancer Therapy: Attempts to Overcome Their Unfavorable Side Effects.

Cancers (Basel). 2023-1-12

[2]
FinnGen provides genetic insights from a well-phenotyped isolated population.

Nature. 2023-1

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Food Chem Toxicol. 2023-2

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Annu Rev Pharmacol Toxicol. 2023-1-20

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JAMA. 2022-4-26

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NSAIDs and Cancer Resolution: New Paradigms beyond Cyclooxygenase.

Int J Mol Sci. 2022-1-27

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Temperature (Austin). 2021-3-16

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World J Gastroenterol. 2021-7-28

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