| | 肠癌专题 >> Statins类药物可能降低大肠癌再发率 |
|
|
| Statins类药物可能降低大肠癌再发率 | |
研究者指出，statins类药物降低被诊断罹患第一、二或三期大肠癌病患再发机率；这项研究结果发表於最近的美国临床肿瘤学会（ASCO）第43届年会，研究者表示，目前热门的降血脂药物，在已经切除大肠病灶患者身上扮演重要角色。 主要作者明尼苏达州圣保罗地区医院Daniel Anderson医师在发表会中表示，89位接受statins类药物治疗的病患中仅有6位（6.7%）再发，相对於269位未使用statins类药物病患则有43位（16%）再发；费雪检定的P值為0.03，再发曲线的存活分析结果显示，不同组之间的再发率有显著差异，statins类药物使用者的2年再发率為3.7%、相较於未使用statins类药物病患则是3.7%（Log-rank检定结果P值為0.03，以年龄分组）。 研究者表示，许多研究指出statins类药物可以降低发生大肠与其他癌症的风险，但是并非所有研究都证实这些结果；本週稍早由Medscape所报导的，一项发表於7月31日美国心臟医学会会刊的研究结果显示，降低低密度脂蛋白所带来的心臟血管好处，会被癌症风险上升所抵销；在针对收纳於大型、随机分派研究的病患进行分析，研究者观察到，在目标胆固醇浓度与新癌症病例风险之间有显著且呈线性的关係。 在这项於ASCO报告的研究中，Anderson医师与其明尼苏达布朗明顿健康伙伴研究基金会的同事一起进行这项回溯性分析，对象為接受治疗的第一、二与三期大肠癌患者。 病患透过医院的癌症登记试验收纳入分析，所有病例接著於健康维持组织（HMO）会员资料库进行交叉比对，有关於使用statins类药物的资料，由HMO门诊病患药物资料库取得。 【降血脂药物是否於已切除病灶病患身上扮演角色？】 针对每位病患，研究者取得5年间、从被诊断罹患癌症到再发、或是最近一次记录所有可获得的资料；Andrson医师与其团队自肿瘤登记试验的statins类药物使用记录，将人口流行病学与存活数据合併；研究者接著分析statins类使用者与非使用者再发与疾病再发所需时间数据。 他们针对358為大肠癌患者，这些患者在诊断罹患大肠癌后平均后续追踪时间為49个月，总共有89位（24.9%）病患於某些时段使用statins类药物，使用天数中位数為780天；收纳入这项研究的病患，年龄中位数為69岁（范围从24~95岁）。 老年病患使用statins类药物比例较高，61至75岁（33%）使用statins类药物的比例比24至60岁高（22%），但是年纪更大（76至95岁）的病患，使用statins类药物的比例反而降低（19%；P=0.02）。 研究者发现，使用statins类药物与大肠癌再发风险下降有关，他们观察到使用statins类药物与诊断分期之间无关；但是Anderson医师提醒，未来需要更多的研究来确认statins类药物与预防大肠癌再发之间的关係。 Statins May Cut Colon Cancer Recurrence July 26, 2007 (Chicago) — Researchers report that statins decreased the risk for recurrence in patients diagnosed with stage 1, 2, or 3 colon cancer. Presenting at the recent American Society of Clinical Oncology (ASCO) 43rd Annual Meeting, investigators say the popular lipid-lowering agents may have an important role to play in patients with resected disease. \"Just 6 of 89 patients (6.7%) treated with any statin relapsed, as opposed to 43 of 269 (16%) patients with no statin use,\" lead author Daniel Anderson, MD, from Regions Hospital, in St. Paul, Minnesota, said during his presentation. The Fisher’s exact test resulted in a P value of .03. Kaplan-Meier analysis of relapse curves showed a significant difference in relapse between groups, with a 2-year recurrence rate of 3.7% among statin users and 10.1% among nonusers (log rank P = .03, using age stratification). The investigators reported that a significant body of research suggests that statin use reduces the risk of developing colon and other cancers. But not all studies have confirmed these findings. As reported by Medscape earlier this week, a study published in the July 31 issue of the Journal of the American College of Cardiology suggests the cardiovascular benefits of achieved levels of low-density lipoprotein cholesterol might be offset by an increased risk for cancer. In the analysis of patients enrolled in large, randomized statin trials, investigators observed a significant and linear relationship between target cholesterol levels and the risk for new cancer cases. In the study reported at ASCO, Dr. Anderson, working with colleagues from the Health Partners Research Foundation, in Bloomington, Minnesota, conducted a retrospective analysis of patients treated for stage 1, 2, or 3 colon cancer. Patients were identified through a hospital tumor registry. All cases were then crosschecked against a health maintenance organization (HMO) membership database. Information on statin use was obtained from the HMO outpatient pharmacy database. Could Lipid-Lowering Agents Play a Role in Resected Disease? For each patient, investigators obtained all available data from a 5-year period before first diagnosis of cancer until recurrence or most recent documentation. Dr. Anderson and his team combined demographic and survival data from the tumor registry with pharmacy data on statin use. The researchers then analyzed recurrence and time to recurrent disease in statin users and nonusers. They looked at 358 colon cancer cases. The median follow-up of patients after diagnosis of colon cancer was 49 months. A total of 89 patients (24.9%) used statins for some period of time, with a median of 780 days of use. The median age of all patients enrolled was 69 years (range, 24 – 95 years). Statin use was higher in older patients. Those aged 61 to 75 years (33%) were more likely to be taking lipid-lowering agents than those aged 24 to 60 years (22%). But older patients were also more likely to be taking statins than their elderly counterparts — those aged 76 to 95 years (19%) (P = .02). The researchers found that statin use was linked to a reduced risk for colon cancer recurrence. They observed no association between statin use and stage at diagnosis. But Dr. Anderson cautioned, \"Further study of statin use in the prevention of colon cancer recurrence is warranted.\" American Society of Clinical Oncology 43rd Annual Meeting: Abstract 4114. Presented June 4, 2007. 发布时间：2007年08月05日 |
|
| 【推荐好友】 【发表评论】 |