阿司匹林对降低大肠癌发病率的临床研究(2)
 |
| 第1页 |
参见附件(1345KB，2页)。
综上所述,阿司匹林能降低大肠癌发病率不仅有流行病学依据,也有理论依据支持,但是目前尚未见到多中心、前瞻性、大宗病例临床研究。结直肠癌发病率国际2%水平,国内5%,因此,大多数人无需长期服用阿司匹林来预防结肠癌,毕竟阿司匹林可以引起一些并发症。但我们建议大肠癌高危人群应该服用阿司匹林来降低大肠癌的发生,如有肿瘤家族史,喜食高蛋白、高脂肪、不喜欢蔬菜高纤维素饮食者,有结核病、慢性溃疡性结肠炎以及经常出现便血的人是肠癌高危人群。大肠癌的病因除环境因素和生活方式有关外,遗传因素也是大肠癌的重要病因之一,大肠癌患者子女患大肠癌的危险性比一般人群高2~4倍,在大肠癌患者一级亲属(包括父母、兄弟姐妹、子女)中,遗传因素对大肠癌的影响达到16.8%,通过对遗传性大肠癌的早期诊断和家属的追踪,及早发现癌前病变,提高早期诊断率,减少大肠癌的发病率有重要的指导意义。对于这类人群除了定期检查外也应该通过长期服用阿司匹林来预防或减少大肠癌的发病率。
参考文献
[1] Bosetti C,Gallus S,La Vecchia C.Aspirin and cancer risk:an updated quantitative review to 2005.Cancer causes&control,2006,17(7).
[2] Hawk E,Patterson S.Aspirin:anticolorectal adenocarcinoma activity in the adjuvant arena.Future Oncol,2010,6(2):197-200.
[3] Haile RW,Yochim M,Cortessis VK,et al.A molecular/epidemiologic analysis of expression of cyclooxygenases 1 and 2,use of monsteroidal anti-inflammatory drugs,and risk of colorectal adenoma.Clin Colorectal Cancer,2005,4(6):390-395.
[4] Flossmann E,Rothwell PM.Effect of aspirin on long-term risk of colorectal cancer:consistent evidence from randomised and observational studie.Lancet,2007,369(9573):1603-1613.
[5] Martin LJ,Chen K,Liu Z.Aault motor neuron apoptosis is mediated by nitric oxide and Fas death receptor linked by DNA damage and p53 activation.J Neurosci,2005,25(27):6449-6459.
[6] 钟守琳,周剑涛.释放一氧化氮型阿司匹林的抗癌作用机制,生命化学,2008,28(1):20-22.
[7] Chan AT,Ogino S,Fuchs CS.Aspirin and the risk of colorectal cancer in relation to the expression of COX-2.N Engl J Med,2007,356(21):2131-2142.
[8] Hagos GK,Carroll RE,Kouznetsova T,et al.Colon cancer chemoprevention by a novel NO chimera that shows anti-inflammatory and antiproliferative activity in vitro and in vivo.Molecular cancer therapeutics,2007,6(8):2230-2239.
您现在查看是摘要介绍页，详见PDF附件(1345KB，2页)。