常见止痛药对乳腺癌风险和存活率的差异性因果影响:来自孟德尔随机化的证据
Zhan Peng1, Zhuobin Liu1, Guangye Wang1
1Department of Spinal Surgery, Shenzhen Baoan District People's Hospital, the Second Affiliated Hospital of Shenzhen University, Shenzhen, People's Republic of China.
International journal of women's health
|December 15, 2025
概括
遗传倾向于使用甲会增加乳腺癌风险,特别是ER+,而使用阿司匹林可以改善存活率. 这表明药物特异性效应,需要谨慎使用青,并进一步研究阿司匹林.
科学领域:
- 药物基因组学和癌症流行病学
- 调查常见止痛药和乳腺癌结果之间的因果关系.
背景情况:
- 围绕着麻 (乙氨基),阿司匹林 (乙酸) 和布洛芬对乳腺癌风险和存活率的因果作用的不确定性.
- 乳腺癌中的雌激素受体 (ER) 亚型异质性可能会受到止痛药的使用的影响.
研究的目的:
- 调查对止痛药使用的遗传倾向与乳腺癌发病率,死亡率和ER亚型异质性之间的因果关系.
- 评估止痛药使用与乳腺癌之间的潜在反向因果关系.
主要方法:
- 两个样本的孟德尔随机化 (MR) 研究,使用来自英国生物银行GWAS (N=457,547) 的用于止痛的遗传仪器.
- 结果数据包括乳腺癌发病率 (122,977例/105,974对照),ER亚型 (ER+: 69,501例;ER-: 21,468例) 和生存统计数据.
- 主要分析使用了反变量加权 (IVW) 方法,并补充了MR-Egger,加权中位数/模式和灵敏度分析 (MR-PRESSO,留出一项);双向MR评估了反向因果关系.
主要成果:
- 基因预测的类醇使用与整体乳腺癌风险增加 (OR=3.26) 和ER+亚型风险增加 (OR=3.65) 相关.
- 服用阿司匹林与发病率没有关联,但与改善整体存活率 (HR=0.0036) 有关.
- 布洛芬与乳腺癌风险或存活率没有显著的关联;灵敏度分析证实了强度和最小的性.
结论:
- 对降醇使用的遗传倾向与乳腺癌风险增加有关,特别是ER+亚型.
- 相反,阿司匹林的使用似乎可以改善乳腺癌的存活率,这表明药物特定的机制.
- 结果表明,长期使用片剂应谨慎,并强调阿司匹林的潜在治疗作用,需要对这些风险和益处进行临床考虑.
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