2012年8月28日 訊 /生物谷BIOON/ --一項(xiàng)新的研究著重闡述了阿司匹林與癌癥風(fēng)險(xiǎn)和死亡率之間的關(guān)系,，提示該藥可能會(huì)降低死于前列腺癌的風(fēng)險(xiǎn),，但研究并沒(méi)有證實(shí)阿司匹林能顯著下降罹患乳腺癌的風(fēng)險(xiǎn),。
芝加哥醫(yī)學(xué)中心大學(xué)輻射和細(xì)胞腫瘤學(xué)系副教授Stanley Liauw博士解釋說(shuō)：這一項(xiàng)研究是一種不同類(lèi)型的研究,。乳腺癌研究小組一直在尋找阿司匹林是如何能影響癌癥的形成的,，而我們看到的是它是如何能抑制癌癥發(fā)展的,。根據(jù)以往的研究,，我們可能得知阿司匹林的防癌好處,。在這項(xiàng)有關(guān)阿司匹林對(duì)前列腺癌患者死亡的研究中,，我們居然看到了一個(gè)相當(dāng)顯著的效果。
這一研究結(jié)果發(fā)表在8月27日的Journal of Clinical Oncology雜志,。乳腺癌的研究團(tuán)隊(duì)在波士頓Brigham和婦女醫(yī)院醫(yī)學(xué)講師 Xuehong Zhang博士的帶領(lǐng)下,。乳腺癌是美國(guó)婦女最常見(jiàn)的癌癥之一。以前的研究表明,，常規(guī)服用阿司匹林和/或非甾體類(lèi)抗炎藥（NSAID）能減少結(jié)腸癌癥的風(fēng)險(xiǎn),，哈佛研究人員試圖看是否阿司匹林對(duì)乳腺癌可能具有類(lèi)似功效。
在1980年和2008年,，該小組跟蹤了近85,000名絕經(jīng)后婦女,。幾乎每隔兩年，婦女完成她們的病歷和生活方式問(wèn)卷調(diào)查,。詢(xún)問(wèn)她們常規(guī)使用阿司匹林和/或其他非甾體抗炎藥情況,。在過(guò)去的三十年中,，4700多名女性罹患了某種形式的浸潤(rùn)性乳腺癌。然而,，Zhang的研究小組發(fā)現(xiàn),，無(wú)論是定期服用阿司匹林或其他非甾體抗炎藥，其對(duì)整體患乳腺癌的風(fēng)險(xiǎn)沒(méi)有任何顯著影響,，無(wú)論她們使用了多少該類(lèi)藥物,。
與此同時(shí)，Liauw和他的團(tuán)隊(duì)研究使用阿斯匹林與6000名前列腺癌患者之間的潛在利益,。這些來(lái)自美國(guó)41個(gè)不同的健康中心,，都經(jīng)歷了手術(shù)根治性前列腺切除術(shù)或放射治療。該小組指出,，有37％的患者服用一些抗凝血?jiǎng)ò⑺酒チ?、氯吡格雷（Plavix）、華法林（香豆）和/或依諾肝素）,。
沒(méi)有服用阿司匹林或其他抗凝血?jiǎng)┰谘芯块_(kāi)始時(shí)就被標(biāo)注出來(lái)。經(jīng)過(guò)超過(guò)10年的隨訪研究,，研究小組發(fā)現(xiàn),，在服用某種類(lèi)型的抗凝血?jiǎng)┖螅烙谇傲邢侔┑娘L(fēng)險(xiǎn)顯著低于那些不服用者,。進(jìn)一步分析發(fā)現(xiàn),，大部分的效益來(lái)自于使用阿司匹林，Liauw說(shuō)前列腺癌死亡的風(fēng)險(xiǎn)減少了57％主要是由使用阿司匹林帶來(lái)的,。
由于劑量信息沒(méi)有收集,，因此沒(méi)有結(jié)論可以證實(shí)到底有多少劑量的阿司匹林是最有利的。然而,，研究小組注意到阿司匹林的保護(hù)作用是最強(qiáng)的,，特別對(duì)“高風(fēng)險(xiǎn)”的疾病患者來(lái)說(shuō)。
兩項(xiàng)研究都證明了阿司匹林的使用與癌癥的原因和結(jié)果之間有關(guān)系,。張Zhang表示雖然阿司匹林對(duì)患乳腺癌的風(fēng)險(xiǎn)顯示沒(méi)有什么好處,，但他并沒(méi)有看到阿司匹林的長(zhǎng)期使用會(huì)帶來(lái)與癌癥有關(guān)的副作用。然而,，對(duì)于尋求降低其患乳腺癌風(fēng)險(xiǎn)的婦女來(lái)說(shuō),，最好的策略仍然是維持理想的體重、鍛煉,、避免長(zhǎng)期使用絕經(jīng)后激素,，并盡量減少酒精的攝入量。（生物谷：Bioon.com）
編譯自：Daily aspirin may help fight prostate cancer, but not breast cancer
doi:10.1200/JCO.2011.41.0308
PMC:
PMID:
Daily aspirin may help fight prostate cancer, but not breast cancerAspirin Use and the Risk of Prostate Cancer Mortality in Men Treated With Prostatectomy or Radiotherapy
Kevin S. Choe, Janet E. Cowan, June M. Chan, Peter R. Carroll, Anthony V. D'Amico and Stanley L. Liauw
Purpose Experimental evidence suggests that anticoagulants (ACs) may inhibit cancer growth and metastasis, but clinical data have been limited. We investigated whether use of ACs was associated with the risk of death from prostate cancer.
Patients and Methods This study comprised 5,955 men in the Cancer of the Prostate Strategic Urologic Research Endeavor database with localized adenocarcinoma of the prostate treated with radical prostatectomy (RP) or radiotherapy (RT). Of them, 2,175 (37%) were receiving ACs (warfarin, clopidogrel, enoxaparin, and/or aspirin). The risk of prostate cancer–specific mortality (PCSM) was compared between the AC and non-AC groups.
Results After a median follow-up of 70 months, risk of PCSM was significantly lower in the AC group compared with the non-AC group (3% v 8% at 10 years; P < .01). The risks of disease recurrence and bone metastasis were also significantly lower. In a subgroup analysis by clinical risk category, the reduction in PCSM was most prominent in patients with high-risk disease (4% v 19% at 10 years; P < .01). The benefit from AC was present across treatment modalities (RT or RP). Analysis by type of AC medication suggested that the PCSM reduction was primarily associated with aspirin. Multivariable analysis indicated that aspirin use was independently associated with a lower risk of PCSM (adjusted hazard ratio, 0.43; 95% CI, 0.21 to 0.87; P = .02).
Conclusion AC therapy, particularly aspirin, was associated with a reduced risk of PCSM in men treated with RT or RP for prostate cancer. The association was most prominent in patients with high-risk disease.
