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住院结节病患者的癌症风险:瑞典的一项随访研究。

Cancer risk in hospitalized sarcoidosis patients: a follow-up study in Sweden.

作者信息

Ji J, Shu X, Li X, Sundquist K, Sundquist J, Hemminki K

机构信息

Center for Family and Community Medicine, Karolinska Institute, Huddinge, Germany.

出版信息

Ann Oncol. 2009 Jun;20(6):1121-6. doi: 10.1093/annonc/mdn767. Epub 2009 Feb 11.

Abstract

BACKGROUND

Sarcoidosis patients show dysregulated immune function, which may be related to subsequent cancer. We examined here the overall and specific cancer risks among Swedish subjects who had been hospitalized for sarcoidosis.

METHODS

A sarcoidosis research database was created by identifying hospitalized sarcoidosis patients from the Swedish Hospital Discharge Register and by linking them with the Cancer Registry. Standardized incidence ratios (SIRs) were calculated for cancers in sarcoidosis patients compared with subjects without sarcoidosis.

RESULTS

A total of 10 037 patients were hospitalized for sarcoidosis during years 1964-2004. Among them 1045 patients developed subsequent cancer, giving an overall SIR of 1.40 and 1.18 for cancer diagnosed later than 1 year of follow-up. A significant excess was noted for skin (squamous cell), kidney and nonthyroid endocrine tumors and additionally for non-Hodgkin's lymphoma and leukemia. Patients with multiple hospitalizations showed high risks.

CONCLUSIONS

A 40% overall excess incidence of cancer was noted among sarcoidosis patients, but the increase was confined mainly to the first year after hospitalization. However, the increased risks of skin cancer and non-Hodgkin's lymphoma and leukemia, especially for those with multiple hospitalizations or hospitalized at old age, call for clinical attention.

摘要

背景

结节病患者表现出免疫功能失调,这可能与随后发生的癌症有关。我们在此研究了因结节病住院的瑞典受试者的总体和特定癌症风险。

方法

通过从瑞典医院出院登记册中识别住院的结节病患者并将他们与癌症登记册相链接,创建了一个结节病研究数据库。计算结节病患者与无结节病受试者相比患癌症的标准化发病比(SIR)。

结果

1964年至2004年期间共有10037例患者因结节病住院。其中1045例患者随后发生癌症,随访1年以后诊断的癌症总体SIR为1.40,1年以后为1.18。皮肤(鳞状细胞)、肾脏和非甲状腺内分泌肿瘤以及非霍奇金淋巴瘤和白血病的发生率显著过高。多次住院的患者显示出高风险。

结论

结节病患者总体癌症发病率过高40%,但增加主要局限于住院后的第一年。然而,皮肤癌、非霍奇金淋巴瘤和白血病风险增加,尤其是多次住院或老年住院患者,需要临床关注。

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