中國醫藥大學機構典藏 China Medical University Repository, Taiwan:Item 310903500/25358
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    题名: Effective Reduction of Gastric Cancer Risk With Regular Use of Nonsteroidal Anti-Inflammatory Drugs in Helicobacter Pylori–Infected Patients
    作者: 吳俊穎(Chun-Ying Wu);吳明賢(Ming-Shiang Wu);郭耿南(Ken N. Kuo);王昶弼(Chang-Bi Wang);陳怡如(Yi-Ju Chen);林肇堂(Jaw-Town Lin)*
    贡献者: 公共衛生學系
    日期: 2010-06
    上传时间: 2010-08-24 11:54:14 (UTC+8)
    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.
    關聯: JOURNAL OF CLINICAL ONCOLOGY 28(18):2952~2957
    显示于类别:[公共衛生學系暨碩博班] 期刊論文

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