徐再靜HSU, TSAI-CHING莊沛樺CHUANG, PEI-HUAPEI-HUACHUANG醫學研究所博士班2026-03-132027-07-3120252025-07-11https://handle.ncl.edu.tw/11296/3824gphttps://scholars.csmu.edu.tw/handle/123456789/5492根據臺灣衛生福利部統計資料，惡性腫瘤和腦血管疾病長期位居國人前五大主要死因，對健康威脅甚鉅。因此如何降低這些疾病風險及找尋老藥新用治療藥物為當前公共衛生重要課題。奧司他韋(Oseltamivir)是常見抗流感病毒藥物，近年來有研究發現它不僅參與抗發炎與免疫調控作用，還可能具有抗腫瘤的作用。最近我們的研究發現奧司他韋可有效誘導人類肝癌細胞死亡及抑制異種移植小鼠的腫瘤生長。然而對於奧司他韋使用與癌症及其他慢性疾病的發展仍不清楚。因此本研究利用2009至2018年臺灣全民健康保險資料庫進行回溯性世代研究，將奧司他韋使用者與非使用者與癌症及中風疾病間進行長期發展關係之探討。結果顯示，相較於未使用者，奧司他韋使用者於日後10年內肝癌發生之風險顯著負相關，並且肝癌診斷分期亦較早。使用過奧司他韋藥物的中風患者，與其10年內死亡風險也呈現顯著負相關。綜合以上研究發現，奧司他韋使用具有降低國人肝癌發生率及中風死亡率之潛力，顯示奧司他韋具有抑制肝癌發展及中風死亡之潛在作用。According to statistical data from Taiwan's Ministry of Health and Welfare, malignant neoplasms and cerebrovascular diseases have consistently ranked among the top five leading causes of death in Taiwan, posing a significant threat to public health. Therefore, identifying strategies to reduce the risk of these diseases and repurposing existing drugs for novel therapeutic applications are critical public health priorities. Oseltamivir, a widely used antiviral medication for influenza, has recently been reported to exhibit anti-inflammatory and immunomodulatory effects, and some reports suggest it may also possess antitumor properties. Our recent studies demonstrated that oseltamivir effectively induces hepatocellular carcinoma (HCC) cell death and inhibits tumor growth in both in vitro and in vivo xenograft mouse model. However, clinical research exploring the association between oseltamivir use and the development of cancer or other chronic diseases remains limited. This dissertation presents a retrospective cohort study using Taiwan’s National Health Insurance Research Database (NHIRD) from 2009 to 2018 to investigate the long-term associations between oseltamivir use and the incidence of cancer and stroke. The results indicated a significant inverse association between Oseltamivir use and the risk of developing hepatocellular carcinoma within 10 years, compared to non-users. Moreover, Oseltamivir users were more likely to be diagnosed at an earlier stage of liver cancer. Among patients who later experienced stroke, prior Oseltamivir use was also significantly associated with a lower 10-year all-cause mortality risk. Taken together, these findings suggest that oseltamivir use may be associated with a reduced risk of liver cancer and improved survival among stroke patients, indicating its potential role in mitigating liver cancer development and stroke-related mortality.奧司他韋癌症中風世代研究Oseltamivircancerstrokecohort studythesis