阿司匹林等环氧化酶抑制剂对食管癌发病风险影响的系统评价与Meta分析(1)
[摘要] 目的 系统评价阿司匹林等环氧化酶抑制剂(COX抑制剂)对食管癌发病风险的影响，以阐明两者间的关系。方法 通过检索PubMed、EMBASE、Cochrane library、CNKI数据库，搜索关于使用阿司匹林/NSAIDs与食管癌发病风险影响的临床研究，使用Stata24.0软件进行Meta分析。 结果 使用COX抑制剂可降低人群患食管癌/食管高度异型增生风险[相对风险RR=0.64，95%CI(0.53～0.77)，P=0.512]，阿司匹林同样能够降低人群患食管癌/食管高度异型增生的风险[RR=0.63，95%CI(0.43～0.94)，P=0.642]，非阿司匹林环氧化酶抑制剂也有效果[RR=0.50，95%CI(0.32～0.78)，P=0.492]，这种化学性预防食管癌作用可能与用药时间相关。 结论 使用阿司匹林/COX抑制剂可以有效降低食管癌的发生率，但目前报道的相关文献仍然较少，需要更多高质量的研究来佐证。
[关键词] 阿司匹林;COX抑制剂;食管癌;发病风险
[中图分类号] R735.1 [文献标识码] A [文章编号] 1673-9701(2020)15-0022-08
Systematic evaluation and Meta-analysis of the effect of cyclooxygenase inhibitors like aspirin on the risk of esophageal cancer
ZHANG Siyuan1， 2 DONG Xinchun2 HAN Songchen2 JIN Dacheng1， 2 WANG Bing1， 2 CHEN Meng1， 2 GOU Yunjiu2
1.Gansu University of Traditional Chinese Medicine， Lanzhou 730000， China; 2.Department of Thoracic Surgery， Gansu Provincial People's Hospital， Lanzhou 730000， China
[Abstract] Objective To systematically evaluate the effect of cyclooxygenase inhibitors(COX inhibitors) like aspirin on the risk of esophageal cancer， to clarify the relationship between the two. Methods By searching PubMed， EMBASE， Cochrane library， CNKI database， clinical studies of the effect of aspirin/NSAIDs use on the risk of esophageal cancer were searched. Meta analysis was performed using Stata24.0 software. Results The use of COX inhibitors can reduce the risk of esophageal cancer/esophageal high-grade dysplasia[relative risk RR=0.64， 95%CI(0.53-0.77)， P=0.512]. Aspirin can also reduce the risk of esophageal cancer/high-grade esophageal dysplasia[RR=0.63， 95%CI(0.43-0.94)， P=0.642]. Non-aspirin cyclooxygenase inhibitors also had an effect[RR=0.50， 95% CI(0.32-0.78)， P=0.492]. The effect of chemical prevention of esophageal cancer may be related to the time of medication. Conclusion The use of aspirin/COX inhibitors can effectively reduce the incidence of esophageal cancer， but there are still relatively few relevant literatures reported， and more high-quality studies are needed to corroborate them.
[Key words] Aspirin; COX inhibitors; Esophageal cancer; Risk of onset
目前，全球1270萬新增癌症病例中有760万人死于癌症[1]，而根治性手术仍然是目前的首选治疗方法[2]。胃癌和食管癌是全球第三和第八大常见癌症，分别占癌症总发病率的6.8%和3.2%[3]，且预后不良(胃癌的5年生存率为29%，食管癌为20%)[4]。鉴于各类癌症，尤其是食管癌的高发病率及致死率的迅速增加，寻求丰富多样的治疗方式迫在眉睫，而这其中，应用潜在的化学预防药物是非常必要的。, 百拇医药(张斯渊 董信春 韩松辰)
[关键词] 阿司匹林;COX抑制剂;食管癌;发病风险
[中图分类号] R735.1 [文献标识码] A [文章编号] 1673-9701(2020)15-0022-08
Systematic evaluation and Meta-analysis of the effect of cyclooxygenase inhibitors like aspirin on the risk of esophageal cancer
ZHANG Siyuan1， 2 DONG Xinchun2 HAN Songchen2 JIN Dacheng1， 2 WANG Bing1， 2 CHEN Meng1， 2 GOU Yunjiu2
1.Gansu University of Traditional Chinese Medicine， Lanzhou 730000， China; 2.Department of Thoracic Surgery， Gansu Provincial People's Hospital， Lanzhou 730000， China
[Abstract] Objective To systematically evaluate the effect of cyclooxygenase inhibitors(COX inhibitors) like aspirin on the risk of esophageal cancer， to clarify the relationship between the two. Methods By searching PubMed， EMBASE， Cochrane library， CNKI database， clinical studies of the effect of aspirin/NSAIDs use on the risk of esophageal cancer were searched. Meta analysis was performed using Stata24.0 software. Results The use of COX inhibitors can reduce the risk of esophageal cancer/esophageal high-grade dysplasia[relative risk RR=0.64， 95%CI(0.53-0.77)， P=0.512]. Aspirin can also reduce the risk of esophageal cancer/high-grade esophageal dysplasia[RR=0.63， 95%CI(0.43-0.94)， P=0.642]. Non-aspirin cyclooxygenase inhibitors also had an effect[RR=0.50， 95% CI(0.32-0.78)， P=0.492]. The effect of chemical prevention of esophageal cancer may be related to the time of medication. Conclusion The use of aspirin/COX inhibitors can effectively reduce the incidence of esophageal cancer， but there are still relatively few relevant literatures reported， and more high-quality studies are needed to corroborate them.
[Key words] Aspirin; COX inhibitors; Esophageal cancer; Risk of onset
目前，全球1270萬新增癌症病例中有760万人死于癌症[1]，而根治性手术仍然是目前的首选治疗方法[2]。胃癌和食管癌是全球第三和第八大常见癌症，分别占癌症总发病率的6.8%和3.2%[3]，且预后不良(胃癌的5年生存率为29%，食管癌为20%)[4]。鉴于各类癌症，尤其是食管癌的高发病率及致死率的迅速增加，寻求丰富多样的治疗方式迫在眉睫，而这其中，应用潜在的化学预防药物是非常必要的。, 百拇医药(张斯渊 董信春 韩松辰)