Gut:PPI促胃癌?认定是否使用PPI的方法可能存在问题

Gut

2018-01-03Letter

16.658

影响因子

原标题:质子泵抑制剂与胃癌风险增加的关联:时间相关的偏差

① Cheung等人报道,在幽门螺旋杆菌(HP)清除治疗后使用质子泵抑制剂(PPI),与胃癌风险增加相关;② 但胃癌风险与PPI使用的显著关联可能来自于两种与时间相关的偏差;③ 第一种偏差:一些患者在接受HP清除治疗后的某个时间段内可能使用过PPI,并且未诊断出胃癌,可能被错误认定为非PPI使用者;④ 第二种偏差:一些患者在接受HP清除治疗后的某个时间段内可能使用过PPI,但在很久后才被诊断出胃癌,可能被错误认定为非PPI使用者。

质子泵抑制剂 胃癌

图片

Title:
Proton-pump inhibitors and increased gastric cancer risk: time-related biases

DOI:
10.1136/gutjnl-2017-315729

Abstract & Authors展开

Abstract:
We read with interest the cohort study by Cheung et al1 reporting that use of proton-pump inhibitors (PPIs) after Helicobacter pylori eradication is associated with an increased risk of gastric cancer (GC). We believe that the significantly elevated HR of GC with PPI use (HR 2.44; 95% CI 1.42 to 4.20) is a consequence of two time-related biases. Immortal time bias was introduced by misclassifying exposure, while latency bias was introduced by not incorporating latency in the exposure definition, a major issue for potential carcinogenic drug effects.

All Authors:
Samy Suissa,Alain Suissa

First Authors:
Samy Suissa

Correspondence:
Samy Suissa

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