Distinct chemopreventive effects of aspirin in diffuse and intestinal-type gastric cancer
Menée au Japon à partir de données portant sur 2 980 personnes ayant utilisé l'aspirine ou un autre anti-inflammatoire non stéroïdien et à partir de données portant sur 2 980 témoins, cette étude évalue les effets chimiopréventifs distincts de l'aspirine et des anti-inflammatoires non stéroïdiens sur l'infiltration de neutrophiles dans les tissus gastriques, le développement de métaplasies intestinales et le risque de cancer de l'estomac de type diffus ou de type intestinal
Introduction : Although aspirin/NSAIDs may have potential preventive effects on several cancers, it remains unclear on gastric cancer. The purpose of this study was to compare the risk of developing gastric cancer and the histological changes of intestinal metaplasia and neutrophil infiltration, between aspirin/NSAIDs users and non-users. Methods : Using an electronic endoscopy database in two hospitals from 1996 to 2017, we analyzed the data from patients with chronic gastritis who received aspirin or NSAIDs prior to upper gastrointestinal endoscopy. One-to-one propensity score matching was performed to compare the proportion of gastric cancer, intestinal metaplasia, and neutrophil infiltration between these drug users and non-users. Results : We analyzed 2082 aspirin users and 2082 non-users as well as 898 NSAIDs users and 898 non-users. Six diffuse-type and 19 intestinal-type gastric cancer, 1243 intestinal metaplasia, and 1503 neutrophil infiltration patients were identified. The proportion of diffuse-type gastric cancer (0.05%) was 80% lower in the aspirin-users compared with the non-users (0.24%), and there was no case of diffuse-type cancer in patients who take aspirin for more than 2 years. In contrast, intestinal-type gastric cancer incidence was significantly higher in the aspirin-users (0.72%) compared with the non-users (0.14%). No significant differences in the incidence of gastric cancer were found between NSAIDs use and non-users. NSAIDs use was significantly associated with decreased proportion of neutrophil infiltration compared with non-users. Conclusion : Aspirin may have distinct effects between intestinal-type and diffuse-type gastric cancer development.