伴骨转移前列腺癌患者在内分泌治疗前长期小剂量口服阿司匹林的抗癌作用研究

郭鹏; 钟小明; 傅承忠

doi:10.13201/j.issn.1001-1420.2020.03.004

伴骨转移前列腺癌患者在内分泌治疗前长期小剂量口服阿司匹林的抗癌作用研究

- 内江市第一人民医院泌尿外科(四川内江, 641000)

详细信息

通讯作者: 郭鹏,E-mail:181759594@qq.com

中图分类号: R737.25

收稿日期: 2018-12-10

Efficacy of long term oral taking low dose aspirin before androgen deprivation therapy for newly diagnosed bone-metastatic prostate cancer patients

- Department of Urology, Neijiang First People's Hospital, Neijiang, Sichuan, 641000, China

More Information

Corresponding author: GUO Peng, E-mail: 181759594@qq.com

Received Date: 10 December 2018

摘要

摘要: 目的:观察伴骨转移的前列腺癌患者在内分泌治疗前长期、小剂量口服阿司匹林有无抑制前列腺癌进展的作用。方法:回顾性分析2005年1月~2013年5月在我院接受内分泌治疗的初诊伴骨转移的前列腺癌患者的临床资料,将内分泌治疗前长期(≥1年)、小剂量(100 mg/d)口服阿司匹林的29例患者纳入阿司匹林组,未口服阿司匹林的167例患者纳入非阿司匹林组。收集两组患者内分泌治疗前、后的相关临床资料;统计内分泌治疗后1年内两组各有多少患者进展到去势抵抗前列腺癌(castration resistant prostate cancer,CRPC)阶段;统计内分泌治疗后5年内两组患者的肿瘤特异性死亡率。结果:内分泌治疗前,阿司匹林组患者中患有冠心病、脑梗塞比例更高;而两组患者的其他指标,如年龄、Gleason评分、血PSA值、TNM分期等比较差异无统计学意义(P>0.05)。阿司匹林组和非阿司匹林组患者内分泌治疗后1年的C反应蛋白(CRP)较内分泌治疗前均显著升高(P=0.002,P=0.000),而两组患者比较差异无统计学意义(P=0.756)。两组患者的早期CRPC发生率比较差异无统计学意义(27.6%vs.34.1%,P=0.490)。内分泌治疗后5年内,两组患者的前列腺癌特异性死亡率比较差异无统计学意义[75.9%(22/29) vs.78.4%(131/167),P=0.757]。结论:伴有骨转移的前列腺癌患者,在接受内分泌治疗前,长期、小剂量口服阿司匹林并无延缓前列腺癌进展的作用。
- 前列腺癌 /
- 阿司匹林 /
- 去势抵抗性前列腺癌 /
- 内分泌治疗 /
- C反应蛋白
Abstract: Objective: To investigate whether long term oral taking low dose aspirinbefore androgen deprivation therapy(ADT) can inhibit tumor development in these newly diagnosed bone-metastatic prostate cancer patients. Method: From Jan. 2005 to May. 2013, 196 patients with newly diagnosed bone-metastatic prostate cancer who received ADT in our institute were enrolled in this study. Twenty-nine long-term(at least one year) oral taking low dose(100 mg/d) aspirin patients before ADT were enrolled group 1, and 167 cases who didn't take aspirin before ADT were enrolled group 2. At the same time, coherent clinical data of all the patients were collected. After being treated with ADT within 1 year, all the patients who progressed to the phase of castration resistant prostate cancer(CRPC) were accounted for. After being treated with ADT within 5 years, the 5-year prostate cancer-specific mortality of the two groups were assessed. Result: Before ADT, the incidence of coronary heart diseaseand cerebral infarction were higher in group 1 than those in group 2. There was no significant difference between the two groups especially in the age, Gleason score, serum prostate-specific antigen(PSA) level or TNM staging and so on(P>0.05). The level of serum C-reactive protein(CRP) in two both groups increased at the 12 th month after ADT(P=0.002, P=0.000), but there was no difference between the two groups(P=0.756). After being treated with ADT within 1 year, the difference in the prevalence of CRPC between groups was not significant(27.6% vs. 34.1%, P=0.490). After being treated with ADT within 5 years, the difference in the incidence of 5-year prostate cancer-specific mortality between groups was not significant[75.9%(22/29) vs. 78.4%(131/167), P=0.757].Conclusion: Long term oral taking low dose aspirin before ADT cannot inhibit tumor development in these newly diagnosed bone-metastatic prostate cancer patients.
- prostate cancer /
- aspirin /
- castrate-resistant prostate cancer /
- androgen deprivation therapy /
- C-reactive protein

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参考文献(27)

[1]	Cervi D,Pak B,Venier NA,et al.Micronutrients attenuate progression of prostate cancer by elevating the endogenous inhibitor of angiogenesis,Platelet Factor-4[J].BMC Cancer,2010,10(1):258.
[2]	Lu YL,Kuang L,Zhu H,et al.Changesin aortic endothelium ultrastructure in male rats following castration,replacement with testosterone and administration of 5α-reductase inhibitor[J].Asian J Androl,2007,9(6):843-847.
[3]	Saylor PJ,Keating NL,Smith MR.Prostate cancer survivorship:prevention and treatment of the adverse effects of androgen deprivation therapy[J].J Gen Intern Med,2009,24(2):S389-394.
[4]	Basaria S.Prostate cancer:cardiovascular mortality and androgen deprivation[J].Nat Rev Urol,2009,6(5):252-253.
[5]	Kintzel PE,Chase SL,Schultz LM,et al.Increased risk of metabolic syndrome,diabetes mellitus,and cardiovascular disease in menreceiving androgen deprivation therapy for prostate cancer[J].Pharmacotherapy,2008,28(12):1511-1522.
[6]	杜晚林,黄国华,杨春林,等.前列腺癌雄激素剥夺治疗对胰岛功能和糖代谢的影响[J].临床泌尿外科杂志,2019,34(8):609-612.
[7]	Cyrus T,Sung S,Zhao L,et al.Effect of low-dose aspirin on vascular inflammation,plaque stability,and atherogenesis in low-density lipoprotein receptor-deficient mice[J].Circulation,2002,106(10):1282-1287.
[8]	Jacobs EJ,Rodriguez C,Mondul AM,et al.A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence[J].JNatl Cancer Inst,2005,97(13):975-980.
[9]	Dasgupta K,Di Cesar D,Ghosn J,et al.Association between nonsteroidal anti-inflammatory drugs and prostate cancer occurrence[J].Cancer J,2006,12(2):130-135.
[10]	Roberts RO,Jacobson DJ,Girman CJ,et al.A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer[J].Mayo Clin Proc,2002,77(3):219-225.
[11]	Gay LJ,Felding-Habermann B.Contribution of platelets to tumour metastasis[J].Nat Rev Cancer,2011,11(2):123-134.
[12]	Goubran HA,Burnouf T,Radosevic M,et al.The platelet-cancer loop[J].Eur J Intern Med,2013,24(5):393-400.
[13]	朱岩,杨宪法,牛远杰,等.术前外周血血小板计数及血小板与淋巴细胞的比值与肾细胞癌预后的关系[J].临床泌尿外科杂志,2019,34(7):522-528.
[14]	Rao GH,Fareed J.Aspirin prophylaxis for the prevention of thrombosis:expectations and limitations[J].Thrombosis,2012,2012:104707.
[15]	Downer MK,Allard CB,Preston MA,et al.Regular Aspirin Use and the Risk of Lethal Prostate Cancer in the Physicians' Health Study[J].Eur Urol,2017,72(5):821-827.
[16]	Flahavan EM,Bennett K,Sharp L,et al.A cohort study investigating aspirin use and survival in men with prostate cancer[J].Ann Oncol,2014,25(1):154-159.
[17]	Cardwell CR,Flahavan EM,Hughes CM,et al.Low-dose aspirin and survival in men with prostate cancer:a study using the UK Clinical Practice Research Datalink[J].Cancer Causes Control,2014,25(1):33-43.
[18]	Assayag J,Pollak MN,Azoulay L.The use of aspirin and the risk of mortality in patients with prostate cancer[J].J Urol,2015,193(4):1220-1225.
[19]	Choe KS,Cowan JE,Chan JM,et al.Aspirin use and the risk of prostate cancer mortality in men treated with prostatectomy or radiotherapy[J].J Clin Oncol,2012,30(28):3540-3544.
[20]	Grytli HH,Fagerland MW,Fosså SD,et al.Association between use of beta-blockers and prostate cancer-specific survival:a cohort study of 3 561 prostate cancer patients with high-risk or metastatic disease[J].Eur Urol,2014,65(3):635-641.
[21]	Jacobs CD,Chun SG,Yan J,et al.Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy[J].Cancer Biol Ther,2014,15(6):699-706.
[22]	Jacobs EJ,Newton CC,Stevens VL,et al.Daily aspirin use and prostate cancer-specific mortality in a large cohort of men with nonmetastatic prostate cancer[J].J Clin Oncol,2014,32(33):3716-3722.
[23]	Dhillon PK,Kenfield SA,Stampfer MJ,et al.Aspirin use after a prostate cancer diagnosis and cancer survival in a prospective cohort[J].Cancer Prev Res(Phila),2012,5(10):1223-1228.
[24]	Nakashima J,Tachibana M,Horiguchi Y,et al.Serum interleukin 6 as a prognostic factor in patients with prostate cancer[J].Clin Cancer Res,2000,6(7):2702-2706.
[25]	Kim Y,Jeon Y,Lee H,et al.The Prostate Cancer Patient Had Higher C-Reactive Protein Than BPH Patient[J].Korean J Urol,2013,54(2):85-88.
[26]	Arthur R,Williams R,Garmo H,et al.Serum inflammatory markers in relation to prostate cancer severity and death in the Swedish AMORIS study[J].Int J Cancer,2018,142(11):2254-2262.
[27]	Watson PA,Arora VK,Sawyers CL.Emerging mechanisms of resistance to androgen receptor inhibitors in prostate cancer[J].Nat Rev Cancer,2015,15(12):701-711.