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遗传性肌营养不良患者的癌症风险:1997 - 2009年台湾地区的一项基于人群的研究

Cancer risk among patients with hereditary muscular dystrophies: a population-based study in Taiwan, 1997-2009.

作者信息

Lin Gen-Min, Li Yi-Hwei

机构信息

Department of Public Health, Tzu-Chi University, Hualien, Taiwan.

出版信息

Chin J Cancer. 2014 May;33(5):256-8. doi: 10.5732/cjc.013.10156. Epub 2014 Jan 2.

Abstract

Muscular dystrophies (MD) comprise a heterogeneous group of hereditary myopathic diseases. In this group, myotonic MD is associated with an increased cancer risk. However, the cancer risk in other types of MD is unclear. To address this gap in knowledge, we assessed data obtained from the Taiwan Health Insurance Program database. A total of 1,272 patients with MD diagnosed between 1997 and 2009 were enrolled. They were followed up for cancer during the same period by record linkage with the cancer certification in Taiwan. Age- and sex-standardized incidence ratios (SIRs) of overall and site-specific cancers were calculated. For congenital and progressive hereditary MD, there were 685 and 505 cases (males: 69.5% and 80.6%), the median ages at diagnosis were 16 and 13 years, and the mean follow-up durations were 7.12 and 5.06 years, respectively. In addition, cancers were developed in 10 patients with congenital MD and 3 patients with progressive hereditary MD. Female MD patients exhibited an increased cancer risk, yielding an SIR of 3.37 [95% confidence interval (CI) = 1.38-8.25] in congenital MD and 2.95 (95% CI = 0.95-9.19) in hereditary progressive MD. Site-specific cancer SIRs were not powered to be significantly different. In conclusion, genetic defects in hereditary MD may increase cancer risks in females and a sex difference should be further investigated.

摘要

肌营养不良症(MD)是一组异质性遗传性肌病。在这组疾病中,强直性肌营养不良症与癌症风险增加有关。然而,其他类型MD的癌症风险尚不清楚。为了填补这一知识空白,我们评估了从台湾健康保险计划数据库获得的数据。共纳入了1997年至2009年间诊断出的1272例MD患者。通过与台湾癌症认证记录联动,在同一时期对他们进行癌症随访。计算了总体和特定部位癌症的年龄和性别标准化发病率比(SIR)。先天性和进行性遗传性MD分别有685例和505例(男性:69.5%和80.6%),诊断时的中位年龄分别为16岁和13岁,平均随访时间分别为7.12年和5.06年。此外,10例先天性MD患者和3例进行性遗传性MD患者发生了癌症。女性MD患者的癌症风险增加,先天性MD的SIR为3.37 [95%置信区间(CI)= 1.38 - 8.25],遗传性进行性MD的SIR为2.95(95% CI = 0.95 - 9.19)。特定部位癌症的SIR没有显著差异。总之,遗传性MD中的基因缺陷可能会增加女性的癌症风险,性别差异应进一步研究。

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