质子抑制剂和结直肠癌全因死亡率
Arunkumar Krishnan1,2,3, Carolin V Schneider4, Kunal C Kadakia5,6
1Department of Supportive Oncology, Atrium Health Levine Cancer, Charlotte, NC, USA. dr.arunkumar.krishnan@gmail.com.
Scientific reports
|July 2, 2025
概括
质子抑制剂 (PPI) 的使用与结直肠癌 (CRC) 患者的死亡率较高有关. 这项大型研究发现,目前和前PPI使用者患有CRC的全因死亡风险增加.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 质子抑制剂 (PPI) 被广泛使用,但它们对结直肠癌 (CRC) 患者结局的影响尚未得到充分确立.
- 了解PPI使用与CRC死亡率之间的关联对于患者管理至关重要.
研究的目的:
- 评估新诊断患有结直肠癌 (CRC) 的患者使用质子抑制剂 (PPI) 和全因死亡率之间的关联.
主要方法:
- 用美国超过8000万名患者的电子病历进行回顾性队列研究.
- 包括252,022名首次CRC诊断的成年患者 (2010-2022年),根据PPI使用者和非使用者的倾向得分与1:1匹配.
- 主要结局是全因死亡率,有6个月的滞后时间来最大限度地减少偏差和至少一年的随访.
主要成果:
- 使用PPI的患者在1年 (HR=1.42),2年 (HR=1.44) 和整体随访 (HR=1.40) 时表现出明显更高的全因死亡风险.
- 增加的死亡风险甚至在以前的PPI使用者中也存在 (HR=1.39).
- 敏感性和辅助分析,包括与基因素-2受体对抗剂的比较,支持了主要发现.
结论:
- 使用质子抑制剂与结直肠癌患者全因死亡风险增加有关.
- 这些发现表明,需要仔细考虑在CRC患者处方PPI,并进一步研究潜在机制.
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