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台湾地区基于人群的研究:银屑病合并糖尿病患者易发生消化道器官癌症。

Psoriatic patients with diabetes are prone to develop digestive organ cancers: a population-based study in Taiwan.

机构信息

Department of Dermatology, Kaohsiung Medical University Hospital, Taiwan.

出版信息

J Dermatol Sci. 2012 Nov;68(2):82-8. doi: 10.1016/j.jdermsci.2012.08.004. Epub 2012 Aug 28.

Abstract

BACKGROUND

Psoriasis is an inflammatory skin condition. Epidemiology studies from different parts of the world have shown that psoriasis is associated with different components of metabolic syndrome. The association between psoriasis and development of cancer has not yet been clearly established.

OBJECTIVE

We hypothesize that chronic inflammation is the driving force that enhances the risk of malignancy in psoriatic patients and suspect that psoriatic patients have higher risks for developing cancers that are most prevalent in the studied population.

METHODS

Using the nested case-control approach derived from the Taiwanese population-based cohort, the current study was launched to validate this hypothesis. Results 8180 psoriatic patients and 163,600 age-matched controls were included in this study. Psoriatic patients were 1.20 folds (95% CI=1.06-1.36; p=0.004) more likely than controls to develop cancer. Further analyses revealed that incident cancers derived from digestive tract, the most common cancer origin found in Taiwanese population, were most significantly associated psoriasis. Patients with psoriasis and diabetes mellitus, a frequent comorbid condition independently associate with both psoriasis and cancer, conferred the highest risk for developing digestive tract cancers, having risks of 1.98 folds (95% CI: 1.11-3.52) and 1.68 folds (95%CI: 1.23-2.28) for the 41-60 years-old and 61-80 years-old age group, respectively. Both psoriasis and diabetes were independently associated with development of digestive tract cancers in the 41-60 years-old patient group.

CONCLUSION

Prevalent cancers in the population should be carefully monitored in the psoriatic patients after middle age (beyond 40 years of age) especially for those with concomitant diabetic conditions.

摘要

背景

银屑病是一种炎症性皮肤病。来自世界各地的流行病学研究表明,银屑病与代谢综合征的不同成分有关。银屑病与癌症发展之间的关系尚未明确。

目的

我们假设慢性炎症是增强银屑病患者发生恶性肿瘤风险的驱动力,并怀疑银屑病患者发生研究人群中最常见癌症的风险更高。

方法

本研究使用来自台湾人群为基础的队列的嵌套病例对照方法来验证这一假设。结果共纳入 8180 例银屑病患者和 163600 名年龄匹配的对照者。银屑病患者发生癌症的风险是对照组的 1.20 倍(95%CI=1.06-1.36;p=0.004)。进一步分析显示,来源于消化道的新发癌症是台湾人群中最常见的癌症起源,与银屑病的相关性最显著。患有银屑病和糖尿病,这两种常见的共病状况与银屑病和癌症均独立相关,使发生消化道癌症的风险最高,41-60 岁和 61-80 岁年龄组的风险分别为 1.98 倍(95%CI:1.11-3.52)和 1.68 倍(95%CI:1.23-2.28)。在 41-60 岁的患者中,银屑病和糖尿病均与消化道癌症的发生独立相关。

结论

银屑病患者在中年(40 岁以上)后,应密切监测人群中常见的癌症,特别是合并糖尿病的患者。

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