| 摘要: | Purpose
Nonsteroidal anti-inflammatory drugs (NSAIDs) play protective roles in gastric carcinogenesis.
However, the interaction between NSAIDs and Helicobacter pylori (H pylori) infection and the
number needed to treat to prevent gastric cancer remains unclear.
Patients and Methods
We conducted a nationwide retrospective cohort study based on data from the Taiwan National
Health Insurance Database. Hospitalized patients with a primary diagnosis of peptic ulcer disease
were selected. Overall, 52,161 patients were divided into non-NSAID user and regular NSAID user
cohorts. Standardized incidence ratios (SIRs), cumulative incidences, and hazard ratios (HRs)
were calculated.
Results
Patients with peptic ulcers who never used NSAIDs had higher risk of gastric cancer compared
with the general population (SIR, 2.11; 95% CI, 2.07 to 2.15), but regular NSAID use conferred
lower risk (SIR, 0.79; 95% CI, 0.77 to 0.81). The protective role of NSAID use was observed in
patients with gastric ulcer, but not in patients with non–H pylori-associated duodenal ulcer. On
multivariate analysis, regular NSAID use was an independent protective factor for gastric cancer
development (HR, 0.79 for each incremental year; P .001), especially in H pylori-associated
patients (HR, 0.52 for each incremental year; P .001). Among patients with H pylori-infected
gastric ulcers, the NNT to prevent a gastric cancer was 50.
Conclusion
Regular NSAID use may be a feasible way to prevent gastric cancer, at least in patients with
gastric ulcers, and especially in H pylori-infected subjects. |
