恶性贫血的诊断与胰腺癌风险
Diagnosis of pernicious anemia and the risk of pancreatic cancer.
作者信息
Shah Pari, Rhim Andrew D, Haynes Kevin, Hwang Wei-Ting, Yang Yu-Xiao
机构信息
From the *Department of Medicine, Gastroenterology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY; and †Division of Gastroenterology, Department of Medicine, and ‡Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
出版信息
Pancreas. 2014 Apr;43(3):422-6. doi: 10.1097/MPA.0000000000000054.
OBJECTIVES
A number of studies have demonstrated a trophic effect of gastrin on pancreatic cancer cells in vitro. Pernicious anemia (PA) is a clinical condition characterized by chronic hypergastrinemia. The aim of this study was to determine if PA is a risk factor for pancreatic cancer.
METHODS
This study is a retrospective cohort study using The Health Improvement Network database, which contains comprehensive health information on 7.5 million patients in the United Kingdom from 1993 to 2009. All patients with PA in the study cohort were identified and composed of the exposed group. Each exposed patient was matched on practice site, sex, and age with up to 4 unexposed patients without PA. The outcome was incident pancreatic cancer. The hazard ratio and 95% confidence intervals were estimated using multivariable Cox regression analysis.
RESULTS
We identified 15,324 patients with PA and 55,094 unexposed patients. Mean follow-up time was similar between groups (exposed 4.31 [SD, 3.38] years, unexposed 4.63 [SD, 3.44] years). The multivariable adjusted hazard ratio for pancreatic cancer associated with PA was 1.16 (95% confidence interval, 0.77-1.76; P = 0.47).
CONCLUSIONS
There is no significant association between PA and the risk of pancreatic cancer.
目的
多项研究已证实在体外胃泌素对胰腺癌细胞有营养作用。恶性贫血（PA）是一种以慢性高胃泌素血症为特征的临床病症。本研究的目的是确定PA是否为胰腺癌的一个危险因素。
方法
本研究是一项回顾性队列研究，使用健康改善网络数据库，该数据库包含1993年至2009年英国750万患者的综合健康信息。研究队列中的所有PA患者被识别出来并组成暴露组。每例暴露患者在执业地点、性别和年龄方面与多达4例无PA的未暴露患者进行匹配。结局为新发胰腺癌。使用多变量Cox回归分析估计风险比和95%置信区间。
结果
我们识别出15324例PA患者和55094例未暴露患者。两组之间的平均随访时间相似（暴露组4.31[标准差，3.38]年，未暴露组4.63[标准差，3.44]年）。与PA相关的胰腺癌的多变量调整风险比为1.16（95%置信区间，0.77 - 1.76；P = 0.47）。
结论
PA与胰腺癌风险之间无显著关联。
Zotero 插件