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癌症诊断前的沙门氏菌或弯曲杆菌胃肠炎并不会加重预后:一项基于人群的随访研究。

Salmonella or Campylobacter gastroenteritis prior to a cancer diagnosis does not aggravate the prognosis: a population-based follow-up study.

机构信息

Department of Infectious Diseases, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.

出版信息

APMIS. 2010 Feb;118(2):136-42. doi: 10.1111/j.1600-0463.2009.02571.x.

Abstract

We hypothesized that preceding zoonotic Salmonella or Campylobacter gastroenteritis aggravated the prognosis in cancer patients. Exposed patients comprised all of those diagnosed with first-time Salmonella/Campylobacter gastroenteritis from 1991 and with first-time cancer diagnosis thereafter (through 2003) in two Danish counties. These patients were matched for main cancer type, gender, age and calendar period to unexposed cancer patients, i.e. those without Salmonella/Campylobacter gastroenteritis. We compared cancer stage by age- and comorbidity-adjusted logistic regression analysis, survival by comorbidity-adjusted Cox's regression analysis and mortality dependent on the time period between Salmonella/Campylobacter gastroenteritis and cancer by spline regression curves. The study cohort comprised 272 Salmonella/Campylobacter-exposed cancer patients and 2681 unexposed cancer patients. Prevalence odds ratios [95% confidence intervals (CI)] in exposed as compared with unexposed patients were 0.96 (0.74-1.25) for localized tumours, 1.15 (0.87-1.54) for regional spread and 1.14 (0.84-1.55) for metastases. Adjusted mortality rate ratios (95% CI) were 0.93 (0.75-1.16) for 0-1 year, 1.08 (0.84-1.39) for 2-5 years and 1.02 (0.60-1.73) for the remaining period. Mortality estimates did not change in relation to the time period between gastroenteritis and cancer. Salmonella/Campylobacter gastroenteritis prior to cancer was associated with neither the cancer stage nor a poorer prognosis.

摘要

我们假设先前发生的动物源性病原体(如沙门氏菌或弯曲杆菌)导致的肠胃炎会加重癌症患者的预后。暴露组患者包括丹麦两个县在 1991 年首次确诊为沙门氏菌/弯曲杆菌肠胃炎且随后(直至 2003 年)首次确诊癌症的所有患者。这些患者与未暴露于沙门氏菌/弯曲杆菌肠胃炎的癌症患者(即没有发生过肠胃炎的患者)按主要癌症类型、性别、年龄和日历时间进行匹配。通过年龄和合并症调整的逻辑回归分析比较癌症分期,通过合并症调整的 Cox 回归分析比较生存情况,通过样条回归曲线比较肠胃炎和癌症之间的时间段对死亡率的影响。研究队列包括 272 名暴露于沙门氏菌/弯曲杆菌的癌症患者和 2681 名未暴露于沙门氏菌/弯曲杆菌的癌症患者。与未暴露于沙门氏菌/弯曲杆菌的患者相比,暴露于沙门氏菌/弯曲杆菌的患者中局部肿瘤、区域扩散和转移的患病优势比(95%置信区间)分别为 0.96(0.74-1.25)、1.15(0.87-1.54)和 1.14(0.84-1.55)。调整后的死亡率比值比(95%置信区间)分别为 0-1 年为 0.93(0.75-1.16),2-5 年为 1.08(0.84-1.39),其余时间段为 1.02(0.60-1.73)。死亡率估计值与肠胃炎和癌症之间的时间段无关。癌症前的沙门氏菌/弯曲杆菌肠胃炎与癌症分期或预后不良均无关联。

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