质子泵抑制剂对结直肠癌预后的剂量反应效应仍在探索中。这项在台湾进行的基于人群的研究旨在研究质子泵抑制剂对不同累积质子泵抑制剂剂量水平的结直肠癌患者的总体死亡、结直肠癌特异性死亡和复发的影响。本队列研究基于2005年至2020年台湾癌症登记处和台湾国民健康保险研究数据库。以1:1的频率匹配后，共分析了20,889名使用质子泵抑制剂的使用者和20,889名未使用质子泵抑制剂的使用者。对质子泵抑制剂的累积每日剂量水平进行分层，以探索剂量-反应关系。结直肠癌诊断后，质子泵抑制剂暴露累积定义每日剂量> 60 的全因死亡风险高于非质子泵抑制剂使用者，调整后风险比为 1.10（95% CI：1.04-1.18）。对于复发，质子泵抑制剂暴露累积定义每日剂量> 60 降低了复发风险，调整后的风险比为 0.84（95% CI：0.76-0.93）。本研究证明，结直肠癌患者长期使用质子泵抑制剂会导致死亡风险增加，这与质子泵抑制剂暴露累积规定日剂量>60有关，且在不同剂量下具有不同的剂量反应效应等级。

The dose-response effect of proton pump inhibitors on colorectal cancer prognosis is still under exploration. This population-based study in Taiwan was designed to examine the effect of proton pump inhibitors on overall death, colorectal cancer-specific death, and recurrence in colorectal cancer patients with different cumulative proton pump inhibitor dose levels. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2005 to 2020. After frequency matching with a 1:1 ratio, a total of 20,889 users with proton pump inhibitors and 20,889 without proton pump inhibitors were analyzed. The cumulative defined daily dose level of proton pump inhibitor was stratified to explore the dose-response relationship. A proton pump inhibitor exposure cumulative defined daily dose > 60 after colorectal cancer diagnosis had higher risk of all-cause death than non-proton pump inhibitor users with adjusted hazard ratios of 1.10 (95% CIs: 1.04-1.18). For recurrence, a proton pump inhibitor exposure cumulative defined daily dose > 60 had reduced recurrence risk with an adjusted hazard ratio of 0.84 (95% CIs: 0.76-0.93). This study demonstrated that the long-term use of proton pump inhibitors in patients with colorectal cancer was associated with an increased risk of death that related to the proton pump inhibitor exposure cumulative defined daily dose > 60 and had different dose-response effect in various dose level.