Department of Colorectal Surgery P, Aarhus Hospital, Aarhus University Hospital, Aarhus, Denmark.
Int J Cancer. 2010 Aug 1;127(3):675-84. doi: 10.1002/ijc.25080.
Compromised immune function may increase the risk of anal squamous cell carcinoma (SCC). We examined the risk of anal SCC in patients with HIV infection and other chronic disorders associated with immunosuppression. A population-based cohort study was conducted using the Danish National Patient Registry and the Danish Cancer Registry (DCR). We identified all patients with a first-time hospital contact or procedure for HIV infection, solid organ transplantation or autoimmune disease or a first-time record of haematologic malignancy in the DCR, 1978-2005, and followed these for a subsequent anal SCC, starting follow-up 1 year after diagnosis of the index disease. Standardised incidence ratios (SIRs) were computed as the ratio of observed to expected numbers of anal SCCs, based on national age-, sex- and period-specific rates. Among 4,488 patients with HIV, we observed 21 anal SCCs with 0.3 expected (SIR: 81.1 (95% confidence interval (CI): 51.6-121.9)). Risk of anal SCC was markedly increased among 5,113 solid organ recipients (SIR: 14.4 (CI: 7.0-26.4)) and 30,165 patients with haematologic malignancies (SIR: 2.3 (CI: 1.1-4.2)) but only moderately increased among 242,114 patients with autoimmune diseases (SIR: 1.3 (CI: 1.0-1.6)). SIRs varied according to type of autoimmune disease and were high in patients with Crohn's disease (SIR: 3.1 (CI: 1.2-6.4)), psoriasis (SIR: 3.1 (CI: 1.8-5.1)), polyarteritis nodosa (SIR: 8.8 (CI: 1.5-29.0)) and Wegener's granulomatosis (SIR: 12.4 (CI: 2.1-40.8)). In conclusion, we found HIV infection, solid organ transplantation, haematologic malignancies and a range of specific autoimmune diseases strongly associated with increased risk of anal SCC.
免疫功能受损可能会增加肛门鳞状细胞癌（SCC）的风险。我们研究了感染 HIV 以及其他与免疫抑制相关的慢性疾病患者肛门 SCC 的风险。该研究采用了丹麦全国患者登记处和丹麦癌症登记处（DCR）进行了一项基于人群的队列研究。我们在 DCR 中确定了所有首次因 HIV 感染、实体器官移植或自身免疫性疾病住院或接受治疗的患者，或首次记录血液恶性肿瘤的患者，并从诊断出该疾病后开始随访 1 年，随后观察这些患者是否发生肛门 SCC。标准化发病比（SIR）是通过观察到的肛门 SCC 数量与基于全国年龄、性别和时期特定发病率的预期数量计算得出的比值。在 4488 名 HIV 患者中，我们观察到 21 例肛门 SCC，预期为 0.3 例（SIR：81.1（95%置信区间（CI）：51.6-121.9））。实体器官受者（SIR：14.4（CI：7.0-26.4））和 30165 名血液恶性肿瘤患者（SIR：2.3（CI：1.1-4.2））发生肛门 SCC 的风险显著增加，但 242114 名自身免疫性疾病患者（SIR：1.3（CI：1.0-1.6））的风险仅中度增加。SIR 因自身免疫性疾病的类型而异，在克罗恩病（SIR：3.1（CI：1.2-6.4））、银屑病（SIR：3.1（CI：1.8-5.1））、结节性多动脉炎（SIR：8.8（CI：1.5-29.0））和 Wegener 肉芽肿（SIR：12.4（CI：2.1-40.8））患者中较高。总之，我们发现 HIV 感染、实体器官移植、血液恶性肿瘤和一系列特定的自身免疫性疾病与肛门 SCC 风险增加密切相关。
