Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.
Neuro Oncol. 2013 Sep;15(9):1142-50. doi: 10.1093/neuonc/not070. Epub 2013 Jun 11.
Previous studies have reported increased risk of brain tumors after allergic conditions, but no systematic analyses of these tumors in patients with autoimmune disease (AId) have been performed. No data are available on survival among patients with AId from brain tumors. We analyzed systematically risks and survival in histological types of brain tumors among patients who received a diagnosis of 33 different AIds.
Standardized incidence ratios (SIRs) for brain tumors or hazard ratios (HRs) of deaths after brain tumors were calculated up to 2008 in 402 462 patients hospitalized for AId after 1964 and were compared with data on the population not hospitalized for AIds.
Brain tumors were diagnosed in 880 patients with AId. No increased or decreased risks (SIRs) were noted for glioma, whereas the increased SIRs for meningioma after many AIds were likely to be attributable to surveillance bias. The data on survival showed overall decreases for glioma (HR, 1.15) and meningioma (HR, 1.26). The survival in both was decreased in patients with chronic rheumatic heart disease, multiple sclerosis, and rheumatoid arthritis. Overall, HRs were increased for glioma after 6 AIds and for meningioma after 7 AIds.
The present data showed that none of the 33 AIds influenced the risk of glioma. However, many AIds negatively influence survival in glioma and meningioma, probably through added physical burden or therapeutic limitations. Information of an existing AId in patients with newly diagnosed brain tumors should help the prognostic assessment and the design of treatment.
先前的研究报告称，过敏症后发生脑瘤的风险增加，但尚未对自身免疫性疾病（AId）患者的这些肿瘤进行系统分析。也没有关于 AId 患者脑瘤后生存的数据。我们系统性地分析了在 1964 年后因 AId 住院的 402462 名患者中，33 种不同 AId 患者的组织学类型脑瘤的风险和生存情况。
在 2008 年之前，计算了标准化发病率比（SIR）或脑瘤后死亡的风险比（HR），这些患者在 1964 年后因 AId 住院，与未住院的人群数据进行了比较。
在 880 名 AId 患者中诊断出脑瘤。未发现胶质瘤风险增加或降低（SIR），而许多 AId 后脑膜瘤的 SIR 升高可能归因于监测偏倚。生存数据显示胶质瘤（HR1.15）和脑膜瘤（HR1.26）总体下降。慢性风湿性心脏病、多发性硬化症和类风湿关节炎患者的生存率均下降。总体而言，在 6 种 AId 后胶质瘤和 7 种 AId 后脑膜瘤的 HR 增加。
目前的数据表明，这 33 种 AId 均未影响胶质瘤的风险。然而，许多 AId 对胶质瘤和脑膜瘤的生存产生负面影响，可能是由于身体负担或治疗限制增加。在新诊断为脑瘤的患者中存在现有 AId 的信息应有助于预后评估和治疗设计。
