| <P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> 抗骨质疏松药物双膦酸盐在肿瘤治疗中的应用日益广泛，但近来有研究称口服双膦酸盐与食管癌危险增加相关。不过，在</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">8</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">月</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">11</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">日出版的《美国医学会杂志》（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">JAMA</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">）上，一项英国大规模队列研究结果似乎要为口服双膦酸盐正名。 </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> </SPAN><STRONG><SPAN style="FONT-SIZE: 14pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">英国研究：</SPAN></STRONG><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> <FONT color=#3e3e3e><STRONG><SPAN style="FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"><FONT size=3>食管癌危险与口服双膦酸盐无关</FONT></SPAN></STRONG> </FONT></SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> 英国贝尔法斯特女王大学公共卫生中心的卡德维尔（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">Cardwell</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">）等报告，口服双膦酸盐与食管癌及胃癌发生无显著相关性</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">[JAMA 2010, 304(6): 657]</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">。 </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> 研究者从英国全科医疗研究数据库（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">GPRD</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">）中抽取病例，比较了</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">1996</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">1</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">月至</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">2006</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">11</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">月间口服双膦酸盐者与对照者的食管癌或胃癌发病率。两组均纳入</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">41826</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例患者，平均随访时间分别为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">4.5</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年和</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">4.4</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年。 </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> 结果显示，双膦酸盐组有</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">116</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例患者发生食管癌（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">79</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例）或胃癌，对照组则为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">115</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例（食管癌</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">72</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例），两组食管癌和胃癌总发病率一致，均为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">0.7/1000</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">人</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">-</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年，单独计算食管癌发病率提示两组无显著差异（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">0.48/1000</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">人</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">-</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年对</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">0.44/1000</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">人</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">-</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年）。校正吸烟、酒精摄入、体质指数等混杂因素后，两组发病率仍无显著差异。而且，无论患者口服双膦酸盐种类、服药时间及反流性食管炎病史如何，服用双膦酸盐者和未服用者的食管癌或胃癌危险均无显著差异。（群慧） </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> </SPAN><STRONG><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">FDA</SPAN></STRONG><STRONG><SPAN style="FONT-SIZE: 14pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">报告：</SPAN></STRONG><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> <FONT color=#3e3e3e><STRONG><SPAN style="FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"><FONT size=3>口服双膦酸盐人群现食管癌病例</FONT></SPAN></STRONG> </FONT></SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> 关于口服双膦酸盐致食管癌危险的争论，可以追溯到美国</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">FDA</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">维索斯基（</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">Wysowski</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">）博士的一份报告，该报告发表于《新英格兰医学杂志》</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">[N Engl J Med 2009, 360(1): 89]</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">。 </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> 该报告称，自从</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">1995</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年阿仑膦酸盐在美国上市，至</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">2008</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">5</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">月中旬，</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">FDA</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">已收到</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">23</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例服用该药者被诊断为食管癌的报告，其中</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">8</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例已死亡。从患者开始用药到诊断为食管癌的中位时间为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">2.1</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年。另外，欧洲和日本也报告了</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">31</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例患者在服用阿仑膦酸盐后被诊断为食管癌</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"> </SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">，包括</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">6</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">例死亡病例，从服用药物到诊断为食管癌的中位时间为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">1.3</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">年。</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">Wysowski</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">认为，临床研究应将口服双膦酸盐列为可能的食管癌危险因素。</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"> </SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">（小群） </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P>
<P style="BACKGROUND: white; LINE-HEIGHT: 16.5pt"><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> </SPAN><STRONG><SPAN lang=EN-US style="FONT-SIZE: 14pt; COLOR: #3e3e3e; FONT-FAMILY: Arial">□</SPAN></STRONG><STRONG><SPAN style="FONT-SIZE: 14pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial">点评</SPAN></STRONG><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial"><o:p></o:p></SPAN></P><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA"> <STRONG><SPAN style="FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial"><FONT color=#3e3e3e size=3>复旦大学附属中山医院呼吸科胡洁、白春学教授：</FONT></SPAN></STRONG></SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">2009</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">年</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">1</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">月《新英格兰医学杂志》曾报告口服双膦酸盐人群中出现食管癌、胃癌病例，而</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">2010</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">年</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">JAMA</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">杂志发表的论文则认为两者不相关。该研究回顾性分析比较了英国</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">GPRD</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">数据库中</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">8</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">万余例病例，发现无论是否使用口服双膦酸盐，食管癌、胃癌的总发病率均为</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">0.7/1000</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">人</SPAN><SPAN lang=EN-US style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-fareast-font-family: 宋体">-</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">年，两者无统计学显著差异。而且，无论采用何种双膦酸盐或疗程如何，均未增加食管癌和胃癌的发病风险。如此大样本量的研究应该具有可参考性，但鉴于其为回顾性、非随机对照研究，且口服双膦酸盐可致食管炎，因此对于口服双膦酸盐是否具有致癌性，仍然需要进行前瞻性</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">Ⅲ</SPAN><SPAN style="FONT-SIZE: 10.5pt; COLOR: #3e3e3e; FONT-FAMILY: 宋体; mso-bidi-font-family: Arial; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA">期随机对照临床研究加以验证。此外，如果为避免这一问题，可采用静脉注射双膦酸盐，因为尚无研究表明静脉注射双膦酸盐会引起食管癌或胃癌。</SPAN> |
