Colin-Jones D G, Langman M J, Lawson D H, Vessey M P
Br Med J (Clin Res Ed). 1982 Nov 6;285(6351):1311-3. doi: 10.1136/bmj.285.6351.1311.
Widespread publicity has been given to te possibility that cimetidine treatment might cause gastric cancer. Preliminary data are given from a post-marketing surveillance study in four centres. A total of 9940 patients taking the drug entered study and 9504 were observed for at least a year. Seventy-four cases of gastric cancer were identified in those taking cimetidine, but 23 of these were diagnosed before the use of the drug and 29 others with advanced malignancy had received cimetidine within the previous six months only. Ten of the remaining 22 had gastric cancer diagnosed within a year of starting treatment, and 12 after more than a year; only four of the total group had histologically "early" cancer. The occurrence of gastric cancer a long time after starting cimetidine treatment cannot be explained in every case, but it is noteworthy that in control group (which is not directly comparable) gastric cancer was observed in eight patients. The hypothesis that cimetidine treatment predisposes to gastric cancer cannot be excluded by our findings: in our view, however, they do not support such an association.
西咪替丁治疗可能导致胃癌这一可能性已得到广泛宣传。文中给出了来自四个中心的上市后监测研究的初步数据。共有9940名服用该药物的患者进入研究，其中9504人被观察了至少一年。在服用西咪替丁的患者中确诊了74例胃癌，但其中23例在使用该药物之前就已被诊断，另外29例患有晚期恶性肿瘤的患者仅在之前六个月内服用过西咪替丁。其余22例中，有10例在开始治疗后一年内被诊断为胃癌，12例在一年多之后被诊断；在整个组中只有4例组织学上为“早期”癌症。开始使用西咪替丁治疗很长时间后发生胃癌的情况并非在每种情况下都能解释，但值得注意的是，在对照组（并非直接可比）中有8名患者被观察到患有胃癌。我们的研究结果不能排除西咪替丁治疗易引发胃癌这一假说：然而，在我们看来，这些结果并不支持这种关联。
