Các chất ức chế hệ renin-angiotensin cải thiện khả năng sống sót của bệnh nhân ung thư biểu mô đường mật: một nghiên cứu đồng nhóm khớp theo điểm xu hướng

BMC Cancer - Tập 23 - Trang 1-10 - 2023
Xiao-Xu Zhu1, Jian-Hui Li1, Peng Fang1, Xiao-Fei Qu1, Li-Jian Liang1, Jia-Ming Lai1, Xiao-Yu Yin1
1Department of Pancreato-Biliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

Tóm tắt

Tăng huyết áp là một yếu tố nguy cơ đối với ung thư biểu mô đường mật (CCA). Tác động của các loại thuốc hạ huyết áp đến tiên lượng của CCA vẫn chưa rõ ràng. Đây là một nghiên cứu hồi cứu trên 102 bệnh nhân (56,9% nam giới, với độ tuổi trung vị 66) được chẩn đoán mắc CCA và tăng huyết áp đồng thời và đã trải qua phẫu thuật triệt căn (R0), với thời gian theo dõi trung vị là 36,7 tháng. Phân tích Kaplan-Meier, hồi quy Cox và khớp theo điểm xu hướng (PS) được áp dụng cho phân tích thống kê. Kết quả của phân tích Cox đa biến cho thấy việc sử dụng các chất ức chế hệ renin-angiotensin (RASis) là yếu tố bảo vệ cho thời gian sống không tiến triển (PFS) (tỷ lệ nguy cơ [HR] = 0,55, khoảng tin cậy 95% [95% CI]: 0,32–0,96) và sống sót toàn bộ (OS) (HR = 0,40, 95% CI: 0,20–0,79), tương ứng. Các chất chẹn kênh canxi, thuốc lợi tiểu và β-blockers không cho thấy mối liên quan đáng kể. Mối liên hệ giữa việc sử dụng RASis và PFS cũng như OS được xác định qua khớp theo PS, với một nhóm 28 người sử dụng RASis và 56 người không sử dụng RASis. Thời gian trung vị PFS và OS của những người sử dụng RASis (PFS, 17,6 tháng (9,2–34,4); OS, 24,8 tháng (16,5–42,3)) dài hơn so với những người không sử dụng RASis (PFS, 10,5 tháng (4,1–24,1); OS, 14,6 tháng (10,6–28,4)). Tỷ lệ sống sót sau 1 năm, 2 năm và 3 năm của người sử dụng RASis (89,1%, 77,0% và 65,5%) cao hơn so với người không sử dụng RASis (70,9%, 54,0% và 40,0%). Việc sử dụng RASis cải thiện khả năng sống sót của bệnh nhân đồng mắc CCA và tăng huyết áp.

Từ khóa

#tăng huyết áp #ung thư biểu mô đường mật #chất ức chế hệ renin-angiotensin #sống không tiến triển #sống sót toàn bộ

Tài liệu tham khảo

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