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- Title
Angiotensin I-converting enzyme inhibitors/angiotensin II receptor blockers may reduce tumor recurrence in left-sided and early colorectal cancers.
- Authors
Ozawa, Tsuyoshi; Hashiguchi, Yojiro; Yagi, Takahiro; Fukushima, Yoshihisa; Shimada, Ryu; Hayama, Tamuro; Tsuchiya, Takeshi; Nozawa, Keijiro; Iinuma, Hisae; Ishihara, Soichiro; Matsuda, Keiji
- Abstract
Background: Angiotensin signaling is suggested to be involved in tumorigenesis, tumor proliferation, and metastases. In colorectal cancer (CRC), it was demonstrated that angiotensin I-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) may reduce the risk of CRC; however, their impact on tumor recurrence remains unknown. Therefore, in this study, we evaluated the impact of ACEIs/ARBs on tumor recurrence in CRC patients. Patients and methods: We retrospectively investigated the clinicopathological data of 461 stage I–III CRC patients. We divided the patients into those who took an ACEI and/or ARB (the ACEI/ARB+ group) and those who did not (the ACEI/ARB− group), and we compared the two groups' recurrence-free survival (RFS) using a Kaplan-Meier curve analysis and log rank test. We also examined the impact of AGTR1 expression on tumor recurrence, using two public CRC datasets. Results: The Kaplan-Meier curves showed a trend toward improved RFS in the ACEI/ARB+ group versus the ACEI/ARB− group (p = 0.063). Subgroup analyses demonstrated that the RFS was significantly better in the ACEI/ARB+ group versus the ACEI/ARB− group in the patients with left-sided CRC (p = 0.030) and those with stage I CRC (p = 0.009). Consistent with these findings, the AGTR1 expression was higher in the left-sided versus right-sided colon (p = 0.048). High AGTR1 expression levels were associated with poor RFS in the GSE39582 dataset's stage I–III CRC patients (p < 0.001), and this finding was also validated in the GSE17536 dataset (p = 0.023). Conclusion: ACEI/ARB treatment may reduce tumor recurrence in left-sided CRC and early-stage CRC.
- Subjects
ANGIOTENSIN II; ANGIOTENSIN I; ANGIOTENSIN-receptor blockers; ANGIOTENSIN receptors; ANGIOTENSINS; ENZYME inhibitors; COLORECTAL cancer
- Publication
International Journal of Colorectal Disease, 2019, Vol 34, Issue 10, p1731
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-019-03379-y