睾酮抑制与男性喉及下咽鳞状细胞癌风险
Testosterone Inhibition and Risk of Laryngeal and Hypopharyngeal Squamous Cell Carcinoma in Men.
文献信息
| PMID | 42821291 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Eivind Gottlieb-Vedi |
| 作者单位 | Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. |
| 期刊 | JAMA otolaryngology-- head & neck surgery |
| SCI 分区 | Q1 |
| IF | 7.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
重要性： 喉及下咽鳞状细胞癌最常见于男性。有人假设睾酮可解释这种性别差异，但缺乏相关研究。5α-还原酶抑制剂（5-ARIs）是常用于良性增生男性的药物，可抑制睾酮转化为具有生物活性的双氢睾酮，因而具有抗雄激素特性。
目的： 探讨使用5-ARIs是否与男性喉及下咽鳞状细胞癌风险降低相关。
设计、场所和参与者： 这项基于人群的队列研究纳入瑞典处方药物与健康队列中2005年7月1日至2022年12月31日期间的男性，随访至2023年12月31日。
暴露： 研究期间2年内至少2次配发5-ARIs。将5-ARIs使用者与5倍数量、年龄和日期匹配且无5-ARI使用史的男性进行比较。
主要结局和指标： 主要结局为随访期间新诊断的喉或下咽鳞状细胞癌。多变量Cox回归提供风险比及95% CI，并针对酒精过度消费、吸烟、高血压、高脂血症和糖尿病进行调整。
结果： 共纳入253 010名5-ARIs使用者和1 265 050名非使用者（中位[IQR]年龄，74[67-80]岁）。5-ARI使用者的中位（IQR）随访时间为5.8（2.7-10.1）年，非使用者为4.7（1.0-9.4）年。5-ARI使用者中有215例（0.1%）诊断喉或下咽鳞状细胞癌，非使用者中有1131例（0.1%）。与非使用者相比，使用5-ARIs与喉或下咽鳞状细胞癌风险降低17%相关（调整后风险比，0.83；95% CI，0.72-0.96）。
结论与意义： 在这项队列研究中，使用5-ARIs与下咽和喉鳞状细胞癌相对风险降低相关。这支持睾酮在这些肿瘤发生及男性优势中可能起部分作用。
英文摘要
IMPORTANCE: Laryngeal and hypopharyngeal squamous cell carcinoma most commonly occur in men. It has been hypothesized that testosterone explains this sex difference, but there is a lack of research on the topic. 5α-Reductase inhibitors (5-ARIs) are common medications used for men with benign hyperplasia that inhibit the conversion of testosterone to the bioactive form dihydrotestosterone and, thus, have anti-androgenic properties.
OBJECTIVE: To examine whether use of 5-ARIs is associated with lower risk of laryngeal and hypopharyngeal squamous cell carcinoma in men.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study included men in the Swedish Prescribed Drugs and Health Cohort from July 1, 2005, to December 31, 2022, with follow-up until December 31, 2023.
EXPOSURE: At least 2 dispensations of 5-ARIs within 2 years during the study period. Users of 5-ARIs were compared with 5 times as many age- and date-matched men without history of 5-ARI use.
MAIN OUTCOME AND MEASURES: The main outcome was a new diagnosis of laryngeal or hypopharyngeal squamous cell carcinoma during follow-up. Multivariable Cox regression provided hazard ratios with 95% CIs, adjusted for alcohol overconsumption, tobacco smoking, hypertension, hyperlipidemia, and diabetes.
RESULTS: A total of 253 010 users of 5-ARIs and 1 265 050 nonusers were included (median [IQR] age, 74 [67-80] years). The median (IQR) follow-up time was 5.8 (2.7-10.1) years among the 5-ARI users and 4.7 (1.0-9.4) years among the nonusers. Laryngeal or hypopharyngeal squamous cell carcinoma was diagnosed in 215 (0.1%) of the 5-ARI users and 1131 (0.1%) of the nonusers. Use of 5-ARIs was associated with a 17% lower risk of laryngeal or hypopharyngeal squamous cell carcinoma compared to nonusers (adjusted hazard ratio, 0.83; 95% CI, 0.72-0.96).
CONCLUSIONS AND RELEVANCE: In this cohort study, use of 5-ARIs was associated with a decreased relative risk of hypopharyngeal and laryngeal squamous cell carcinoma. This supports a possible partial role of testosterone in the origin and male predominance of these tumors.