阿司匹林治疗与减少的关联 患者肝细胞癌的风险 与慢性乙型

StephenW

AASLD2017[223]
Association of Aspirin Therapy with Reduced
Risk of Hepatocellular carcinoma in Patients
with Chronic Hepatitis B
Teng-Yu Lee1, Yao-Chun Hsu2, Shi-Hang Yu1, Jaw-Town Lin3,
Ming-Shiang Wu4, Chun-Ying Wu1; 1Division of Gastroenterology
& Hepatology, Taichung Veterans General Hospital, Taichung,
Taiwan; 2Division of Gastroenterology & Hepatology,
E-Da Hospital, Kaohsiung, Taiwan; 3Fu Jen Catholic University,
New Taipei City, Taiwan; 4National Taiwan University Hospital,
Taipei, Taiwan
Background: Aspirin may prevent cancer development,
but clinical evidences in HBV-related HCC remain lacking.
We aimed to investigate the association of aspirin therapy
with HBV-related HCC risk. Methods: In this nationwide
cohort study, medical records were retrieved from the
National Health Insurance Research Database between
years 1998 and 2012. We screened 204,507 patients with
chronic hepatitis B, and patients with other infectious
hepatitis were excluded. After excluding patients with
HCC before the follow-up index dates, 1,553 patients
who continuously received daily aspirin ≥ 90 days were
randomly matched 1: 4 with 6,212 patients who never
received anti-platelet therapy by means of propensity
scores, consisted of baseline characteristics, the index date,
and nucelos(t)ide analogue (NA) use during follow-up.
Both cumulative incidences of and hazard ratios (HRs)
for HCC development were analyzed after adjusting for
competing mortality. Results: The cumulative incidence
of HCC in the treated group was significantly lower than
that in the untreated group in 5 years (2.86%, 95% CI:
1.89-3.83 vs. 5.59%, 95% CI: 4.91-6.27; P< 0.001). In the
multivariable regression analysis, aspirin therapy was
independently associated with a reduced HCC risk (HR
0.63, 95% CI: 0.47-0.85; P= 0.002). Sensitivity subgroup
analyses also verified this association. In addition, older
age (HR 1.03 per year), male gender (HR 2.65), cirrhosis
(HR 1.89), and diabetes mellitus (HR 1.51) were independently
associated with an increased HCC risk, but NA
(HR 0.57) or statin (HR 0.57) use was with a decreased HCC
risk. Conclusion: Aspirin therapy is significantly associated
with a reduced risk of HBV-related HCC.
Disclosures:
Yao-Chun Hsu - Speaking and Teaching: AbbVie, BMS, Gilead
The following people have nothing to disclose: Teng-Yu Lee, Shi-Hang Yu,
Jaw-Town Lin, Ming-Shiang Wu, Chun-Ying Wu

StephenW

223
阿司匹林治疗与减少的关联
患者肝细胞癌的风险
与慢性乙型肝炎
滕玉羽1，姚春春2，施Hang Yu 1，aw Town林3，
吴明祥4，春莹吴1;消化内科
台中退伍军人总医院肝病科，台中，
台湾;二维胃肠病学与肝病学，
台湾高雄爱达医院; 3仁川天主教大学，
台湾新北市; 4国立台湾大学医院，
台北，台湾
背景：阿司匹林可预防癌症发展，
但HBV相关HCC的临床证据依然缺乏。
我们的目的是调查阿司匹林治疗的关联
与HBV相关的HCC风险。方法：在全国范围内
队列研究，病历从
国家健康保险研究数据库
1998年和2012年。我们筛选了204,507名患者
慢性乙型肝炎和其他感染性病人
肝炎被排除在外。排除患者后
HCC术后随访期间，1,553例
谁持续接受阿斯匹林≥90天的
随机匹配1：4与6,212例患者从未
通过倾向接受抗血小板治疗
分数由基线特征，指标日期，
和nucelos（t）ide类似物（NA）在随访期间使用。
累积发生率和风险比（HR）
对于HCC发展进行了调整后的分析
竞争死亡率。结果：累积发病率
的治疗组显着低于对照组
未治疗组在5年内（2.86％，95％CI：
1.89-3.83与5.59％，95％CI：4.91-6.27; P <0.001）。在里面
多变量回归分析，阿司匹林治疗
与HCC风险降低独立相关（HR
0.63,95％CI：0.47-0.85; P = 0.002）。敏感性亚组
分析也证实了这一关联。另外老了
年龄（HR 1.03每年），男性（HR 2.65），肝硬化
（HR 1.89）和糖尿病（HR 1.51）独立
与HCC风险增加相关，但NA
（HR 0.57）或他汀类药物（HR 0.57）用于HCC降低
风险。结论：阿司匹林治疗显着相关
HBV相关HCC的风险降低。
披露：
姚俊春讲话与教学：AbbVie，BMS，Gilead
以下人士没有什么可以透露的：滕钰佑李世宇，
萧山镇，吴明祥吴春英

疯一点好

希望有更进一步的研究，如果阿司匹林真的有预防肝癌的作用那就好了，以后还有什么可怕的呢？

windu

看这几年的文章，阿司匹林越来越神奇了，各种应用

StephenW

阿司匹林是抗炎的, 但剂量非是常重要, 太多可以伤害肝脏.
遗憾的是没有制药公司会做临床研究, 因为没有利润.

smilingcloud

才看到这个帖子。

阿司匹林低剂量长期服用也有出现副作用的风险。

低剂量阿司匹林停药和心血管事件风险：瑞典全国人口群体研究。
https://www.ncbi.nlm.nih.gov/m/pubmed/28947478/
Low-Dose Aspirin Discontinuation and Risk of Cardiovascular Events: A Swedish Nationwide, Population-Based Cohort Study.

windu

剂量和副作用，希望多点这样的数据