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重症肌无力与癌症风险:一项基于人群的病例对照研究。

Myasthenia and risk of cancer: a population-based case-control study.

作者信息

Pedersen E G, Pottegård A, Hallas J, Friis S, Hansen K, Jensen P E H, Gaist D

机构信息

Department of Neurology, Odense University Hospital and Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark (SDU), Odense, Denmark.

出版信息

Eur J Neurol. 2014 May;21(5):773-8. doi: 10.1111/ene.12383. Epub 2014 Feb 26.

Abstract

BACKGROUND AND PURPOSE

To evaluate the association between having non-thymoma myasthenia and the risk of extra-thymic cancer in a population-based setting.

METHODS

A nationwide case-control study was conducted in Denmark based on medical registries. The study included all cases with a first time diagnosis of cancer during 2000-2009. Each case was matched by birth year and gender with eight population controls using risk set sampling. Subjects with myasthenia were identified through a validated register-based algorithm. Conditional logistic regression was used to compute crude and adjusted odds ratios (ORs), with 95% confidence intervals (CIs), for cancer associated with a prior diagnosis of myasthenia.

RESULTS

In all, 233 437 cases and 1 867 009 controls were identified. A total of 80 cases and 518 controls had a prior diagnosis of myasthenia. Myasthenia was not associated with an increased risk of overall cancer (OR 1.1; 95% CI 0.9-1.4). Adjusted ORs for major cancer sites were also close to unity, whereas an elevated risk of lymphomas was observed (OR 2.0; 95% CI 0.8-5.5). Early-onset myasthenia was associated with a slightly increased OR for overall cancer (1.5; 95% CI 1.0-2.3); however, this estimate was based on small numbers.

CONCLUSIONS

Non-thymoma myasthenia was not associated with an increased risk of overall cancer. Larger studies are necessary to evaluate the association between myasthenia and risk of lymphoma and the potential effect modification by age of myasthenia onset in relation to cancer risk.

摘要

背景与目的

在基于人群的研究中评估非胸腺瘤性重症肌无力与胸腺外癌症风险之间的关联。

方法

在丹麦基于医疗登记系统开展了一项全国性病例对照研究。该研究纳入了2000年至2009年期间首次诊断为癌症的所有病例。使用风险集抽样方法,按照出生年份和性别将每个病例与8名人群对照进行匹配。通过经过验证的基于登记系统的算法识别出重症肌无力患者。采用条件逻辑回归计算重症肌无力既往诊断与癌症相关的粗比值比(OR)和调整后比值比,并给出95%置信区间(CI)。

结果

总共识别出233437例病例和1867009名对照。共有80例病例和518名对照曾被诊断为重症肌无力。重症肌无力与总体癌症风险增加无关(OR 1.1;95%CI 0.9 - 1.4)。主要癌症部位的调整后OR也接近1,然而,观察到淋巴瘤风险升高(OR 2.0;95%CI 0.8 - 5.5)。早发型重症肌无力与总体癌症的OR略有升高相关(1.5;95%CI 1.0 - 2.3);然而,该估计基于小样本量。

结论

非胸腺瘤性重症肌无力与总体癌症风险增加无关。需要开展更大规模的研究来评估重症肌无力与淋巴瘤风险之间的关联,以及重症肌无力发病年龄对癌症风险的潜在效应修正作用。

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