Role of chemoprophylaxis with either NSAIDs or statins in patients with Barrett's esophagus

查看全文 作　　者：Panagiotis [1]Tsibouris;Erasmia [1]Vlachou;Peter Edward Thomas [2]Isaacs

机构地区：[1]Gastroenterology Department, NIMTS General Hospital;[2]Gastroenterology Department, Blackpool Victoria Hospital

出　　处：《World Journal of Gastrointestinal Pharmacology and Therapeutics》索引2014年第5卷第1期,共13页

摘　　要：The incidence of esophageal adenocarcinoma,a poor prognosis neoplasia,has risen dramatically in recent decades.Barrett’s esophagus represents the best-known risk factor for esophageal adenocarcinoma development.Non-steroidal anti-inflammatory drugs through cyclooxygenase-2 inhibition and prostaglandin metabolism regulation could control cell proliferation,increase cell apoptosis and regulate the expression of growth and angiogenic factors.Statins can achieve equivalent effects through prenylation and subsequently control of cellular signaling cascades.At present,epidemiological studies are small and underpowered.Their data could not justify either medication as a chemo-preventive agent.Population based studies have shown a 43%reduction of the odds of developing an esophageal adenocarcinoma,leaving out or stating a 25%reduction in patients consuming non-aspirin nonsteroidal antiinflammatory drugs and a 50%reduction in those patients consuming aspirin.They have also stated a 19%reduction of esophageal cancer incidence when statins have been used.Observational studies have shown that non-steroidal anti-inflammatory drugs could reduce theadenocarcinoma incidence in patients with Barrett’s esophagus by 41%,while statins could reduce the risk by 43%.The cancer preventive effect has been enhanced in those patients taking a combination of non-steroidal anti-inflammatory drugs and statins(a 74%decrease).Observational data are equivocal concerning the efficacy of non-steroidal anti-inflammatory drug subclasses.Non-steroidal anti-inflammatory drugs clearly have substantial potential for toxicity,while statins are rather safe drugs.In conclusion,both non-steroidal anti-inflammatory drugs and statins are promising chemopreventive agents and deserve further exploration with interventional studies.In the meanwhile,their use is justified only in patients with cardiovascular disease. 关键词：Esophageal adenocarcinoma Barrett’s ESOPHAGUS NON-STEROIDAL anti-inflammatory drugs Aspirin STATINS Cancer CHEMOPREVENTION

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Role of chemoprophylaxis with either NSAIDs or statins in patients with Barrett's esophagus

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