Department of Ophthalmology, Taipei Medical University Hospital, Taipei, Taiwan.
Ophthalmology. 2011 Jun;118(6):1076-81. doi: 10.1016/j.ophtha.2010.10.008. Epub 2011 Jan 12.
Herpes zoster has been associated with immune suppression, as has an increased risk of cancer. This population-based follow-up study aimed to investigate the risk of a subsequent cancer diagnosis after herpes zoster ophthalmicus (HZO).
A retrospective cohort study.
Retrospective claims data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised all patients with a diagnosis of HZO (International Classification of Diseases, 9th Revision, Clinical Modification code 053.2) in 2003 and 2004 (n=658). The comparison cohort consisted of randomly selected ambulatory care patients, 8 for every patient with HZO (n=5264) matched with the study group on age, gender, monthly income, and urbanization level of the patient's residence.
The Kaplan-Meier method was used to compute 1-year cancer-free survival rate. Stratified Cox proportional hazard regressions were carried out to compute the adjusted 1-year cancer-free survival rate after adjusting for potential confounding factors.
Subsequent claims for all study and comparison patients were captured over a 1-year follow-up period from their index ambulatory care visit to identify whether the patient received a cancer diagnosis during the follow-up period.
During 1-year follow-up, cancer was diagnosed in 4.86% of patients with HZO and 0.53% of patients in the comparison cohort. Patients with HZO had significantly lower 1-year cancer-free survival rates than the comparison cohort. After adjusting for patient age, gender, monthly income, and urbanization level, patients with HZO were found to have a 9.25-fold (95% confidence interval, 5.51-15.55) risk of a subsequent cancer diagnosis than the matched comparison cohort. No significant differences in cancer type were observed between the 2 cohorts.
Herpes zoster ophthalmicus may be a marker of increased risk of being diagnosed with cancer in the following year.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
带状疱疹与免疫抑制有关，癌症风险也会增加。这项基于人群的随访研究旨在调查带状疱疹性眼病（HZO）后诊断出后续癌症的风险。
回顾性队列研究。
分析了来自台湾全民健康保险研究数据库的回顾性索赔数据。研究队列包括 2003 年和 2004 年所有诊断为 HZO（国际疾病分类，第 9 版，临床修正代码 053.2）的患者（n=658）。对照组由随机选择的门诊患者组成，每个 HZO 患者匹配 8 名（n=5264），与研究组在年龄、性别、月收入和患者居住地的城市化水平上相匹配。
使用 Kaplan-Meier 方法计算 1 年无癌症生存率。进行分层 Cox 比例风险回归，以在调整潜在混杂因素后计算调整后的 1 年无癌症生存率。
从指数门诊就诊开始，对所有研究和对照患者进行了为期 1 年的随访，以确定在随访期间患者是否被诊断出患有癌症。
在 1 年的随访期间，HZO 患者中有 4.86%被诊断出患有癌症，而对照组患者中有 0.53%。HZO 患者的 1 年无癌症生存率明显低于对照组。在调整患者年龄、性别、月收入和城市化水平后，发现 HZO 患者随后诊断癌症的风险是匹配对照组的 9.25 倍（95%置信区间，5.51-15.55）。在两组之间未观察到癌症类型有显著差异。
带状疱疹性眼病可能是次年被诊断出患有癌症风险增加的标志。
