Background & Aims

Cholera toxin can act as a modulator of the immune response with anti-inflammatory effects; it reduces development of colon polyps in mouse models of colorectal cancer (CRC). We performed a population-based study to determine whether, in patients with a diagnosis of CRC, subsequent administration of the cholera vaccine (killed Vibrio cholerae O1 whole cells and recombinant cholera toxin B subunit) affects mortality.

Methods

We identified patients from the Swedish Cancer Register who were diagnosed with CRC from July 2005 through December 2012. These patients were linked to the Swedish Prescribed Drug Register to retrieve cholera vaccine use. We used Cox regression analysis to calculate the hazard ratio (HR) of death from CRC and overall mortality in patients with post-diagnostic use of cholera vaccine compared with matched controls.

Results

A total of 175 patients were diagnosed with CRC and given a prescription for the cholera vaccine after their cancer diagnosis. Compared with propensity score-matched controls and adjusted for confounding factors, patients with CRC who received the cholera vaccine had a decreased risk of death from CRC (HR, 0.53; 95% CI, 0.29–0.99) and a decreased risk of death overall (HR, 0.59; 95% CI, 0.37–0.94). The decrease in mortality with cholera vaccination was largely observed, irrespective of patient age or tumor stage at diagnosis or sex.

Conclusions

In a population-based study, we associated administration of the cholera vaccine after CRC diagnosis with decreased risk of death from CRC and overall mortality.

中文翻译：

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一项基于人群的研究表明，使用霍乱疫苗可降低大肠癌患者的死亡风险

背景与目标

霍乱毒素可以起到免疫反应的调节剂的作用，具有抗炎作用。它减少了结肠直肠癌（CRC）小鼠模型中结肠息肉的发展。我们进行了一项基于人群的研究，以确定在患有CRC的患者中，随后接种霍乱疫苗（杀死的霍乱弧菌O1全细胞和重组霍乱毒素B亚基）是否会影响死亡率。

方法

我们从瑞典癌症登记处确定了从2005年7月至2012年12月被诊断为CRC的患者。这些患者与瑞典处方药登记处相关联，以检索霍乱疫苗的使用。我们使用Cox回归分析来计算与匹配的对照组相比，在诊断后使用霍乱疫苗的患者中因CRC死亡的危险比（HR）和总死亡率。

结果

总共175名患者被诊断出患有CRC，并在癌症诊断后开出了霍乱疫苗的处方。与倾向评分匹配的对照组相比，并针对混杂因素进行了调整，接受霍乱疫苗的CRC患者死于CRC的风险降低（HR，0.53； 95％CI，0.29-0.99），总体而言，死亡风险降低（ HR，0.59； 95％CI，0.37-0.94）。无论患者年龄或诊断时的肿瘤分期或性别，在很大程度上都可观察到霍乱疫苗接种导致的死亡率降低。

结论

在一项基于人群的研究中，我们将CRC诊断后的霍乱疫苗接种与CRC死亡风险和总体死亡率降低相关联。