Hemminki K, Li X, Sundquist J, Sundquist K
Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Ann Oncol. 2009 Mar;20(3):574-80. doi: 10.1093/annonc/mdn595. Epub 2008 Sep 2.
Patients diagnosed with Crohn disease (CD) are known to be at an increased risk of bowel cancers and lymphoma. CD is an autoimmune disease and we hypothesize that the patients are predisposed to a wider spectrum of cancers.
A CD research database was constructed by identifying hospitalized CD patients from the Hospital Discharge Register and cancer patients from the Swedish Cancer Registry. Follow-up of 21 788 CD patients first hospitalized during the years 1964-2004 identified 1424 cancer cases. Standardized incidence ratios (SIRs) were calculated by comparing cancers in CD patients with subjects without CD.
In addition to the known sites, many additional sites were in excess in CD patients. These included liver, pancreatic, lung, prostate, testicular, kidney and skin (squamous cell) cancers; nonthyroid endocrine tumors and leukemia. The previously established sites showed the highest SIRs; however, SIRs >2.0 were noted for the novel sites of the liver, testis and kidney. For testicular cancer, the SIR of seminoma was 2.74. Cancer risks were influences by age at first hospitalization for CD but whether the age effects were increasing or decreasing depending on the cancer type.
This large study identified many novel subsequent cancers in CD patients.
已知被诊断为克罗恩病（CD）的患者患肠癌和淋巴瘤的风险增加。CD是一种自身免疫性疾病，我们推测这些患者易患更广泛的癌症。
通过从医院出院登记册中识别住院的CD患者以及从瑞典癌症登记处识别癌症患者，构建了一个CD研究数据库。对1964年至2004年期间首次住院的21788例CD患者进行随访，共识别出1424例癌症病例。通过比较CD患者与非CD患者的癌症发病率，计算标准化发病率（SIR）。
除了已知的部位外，CD患者中许多其他部位的癌症发病率也过高。这些部位包括肝癌、胰腺癌、肺癌、前列腺癌、睾丸癌、肾癌和皮肤（鳞状细胞）癌；非甲状腺内分泌肿瘤和白血病。先前确定的部位显示出最高的SIR；然而，肝脏、睾丸和肾脏等新部位的SIR>2.0。对于睾丸癌，精原细胞瘤的SIR为2.74。癌症风险受CD首次住院年龄的影响，但年龄效应是增加还是减少取决于癌症类型。
这项大型研究在CD患者中发现了许多新的后续癌症。
