阿司匹林而非他汀类药物与胃癌呈逆相关关系，存在持续时间-风险效应：来自胃癌合并项目联盟的结果

Aspirin but not statins is inversely related to gastric cancer with a duration-risk effect: Results from the Stomach Cancer Pooling Project Consortium

CANCER

影响因子:5.1

分区:医学1区 Top / 肿瘤学2区

发表日期:2024 Dec 15

作者: Roberta Pastorino, Denise Pires Marafon, Michele Sassano, Ilda Hoxhaj, Claudio Pelucchi, Linda M Liao, Charles S Rabkin, Rashmi Sinha, Nuno Lunet, Samantha Morais, David Zaridze, Dmitry Maximovich, Nuria Aragonés, Gemma Castaño-Vinyals, Inés Gómez-Acebo, Lizbeth López-Carrillo, Malaquias López-Cervantes, Rossella Bonzi, Federica Turati, Paolo Boffetta, Maria Constanza Camargo, Maria Paula Curado, Jesus Vioque, Zuo-Feng Zhang, Eva Negri, Carlo La Vecchia, Stefania Boccia

DOI: 10.1002/cncr.35510

摘要

已有研究建议阿司匹林和他汀类药物可能具有预防胃癌（GC）的潜在化学预防作用，但先前研究的结果不一致。因此，本研究旨在探讨阿司匹林和他汀类药物的使用与胃癌的关联。对胃癌合并项目联盟中的七项病例对照研究进行了荟萃分析，包括3220例病例和9752例对照。采用两阶段建模分析估算调整潜在混杂因素后阿司匹林和他汀类药物使用与胃癌的关联。结果显示，阿司匹林使用者与非使用者的胃癌比值比（OR）为0.72（95%置信区间 [CI]，0.54-0.95）。阿司匹林的保护作用在无家族史者中更强（OR，0.60；95% CI，0.37-0.95），但在有无家族史者之间存在边界水平的异质性（p = 0.064）。使用阿司匹林≥15年者的胃癌OR降至0.41（95% CI，0.18-0.95）。单独使用他汀类药物与胃癌风险呈逆相关，但无统计学显著性（OR，0.79；95% CI，0.52-1.18）。这些结果提示，尤其是长期使用阿司匹林，与降低胃癌风险相关，而他汀类药物未表现出类似的关联，可能因使用频率较低。

Abstract

Aspirin and statins have been suggested to have potential chemopreventive effects against gastric cancer (GC), although the results of previous studies have been inconsistent. This study therefore aimed to investigate the association between the use of aspirin and statins and GC.A pooled analysis of seven case-control studies within the Stomach Cancer Pooling Project, including 3220 cases and 9752 controls, was conducted. Two-stage modeling analyses were used to estimate the association between aspirin and statin use and GC after adjusting for potential confounders.The pooled odds ratio (OR) of GC for aspirin users versus nonusers was 0.72 (95% confidence interval [CI], 0.54-0.95). The protective effect of aspirin appeared stronger in individuals without a GC family history (OR, 0.60; 95% CI, 0.37-0.95), albeit with borderline heterogeneity between those with and without a family history (p = .064). The OR of GC decreased with increasing duration of aspirin use, with an OR of 0.41 (95% CI, 0.18-0.95) for durations of ≥15 years. An inverse, nonsignificant association with the risk of GC was observed for the use of statins alone (OR, 0.79; 95% CI, 0.52-1.18).These findings suggest that aspirin use, particularly long-term use, is associated with a reduced risk of GC, whereas a similar association was not observed with statins, possibly because of the low frequency of use.