Ko J-H, Peck K R, Lee W J, Huh K, Yoo J R, Kim K, Cho S Y, Ha Y E, Kang C-I, Chung D R, Jung C W, Kim Y-H, Lee N Y, Kim K-M, Song J-H
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.
Eur J Clin Microbiol Infect Dis. 2014 Oct;33(10):1847-53. doi: 10.1007/s10096-014-2107-x. Epub 2014 May 23.
Cytomegalovirus (CMV) gastrointestinal (GI) disease has been noticed frequently in cancer patients, causing abdominal pain, diarrhea, and GI bleeding. However, little is known about its actual incidence, clinical presentation, and the risk factors for its development among cancer patients. To answer these questions, we analyzed all cases that occurred during an 18-year period at our center. A case-control study was performed to identify risk factors for CMV GI disease. Electronic medical records were reviewed from individuals who were admitted and diagnosed with CMV GI disease during the period of January 1995 through March 2013 at a tertiary care center. Two CMV disease-free cancer patients were matched as controls. A total of 98 episodes of CMV GI disease were included in this study, and the overall incidence rate was 52.5 per 100,000 cancer patients, with an increasing trend throughout the study period. According to multivariate analysis, male sex, low body mass index, lymphopenia, hematological malignancy, and steroid use and red blood cell transfusion within 1 month prior to the CMV disease were identified to be independent risk factors. Among these factors, RBC transfusion showed the highest odds ratio (OR = 5.09). Male sex, low body mass index, lymphopenia, hematological malignancy, steroid use, and red blood cell transfusion within 1 month prior to the CMV disease diagnosis were independent risk factors for the development of CMV GI disease in adult patients with cancer.
巨细胞病毒（CMV）胃肠道疾病在癌症患者中屡见不鲜，可引发腹痛、腹泻及胃肠道出血。然而，对于其实际发病率、临床表现以及癌症患者中该疾病发生的危险因素，人们所知甚少。为回答这些问题，我们分析了本中心18年间发生的所有病例。开展了一项病例对照研究以确定CMV胃肠道疾病的危险因素。对1995年1月至2013年3月期间在一家三级医疗中心住院并被诊断为CMV胃肠道疾病的患者的电子病历进行了回顾。选取两名无CMV疾病的癌症患者作为对照。本研究共纳入98例CMV胃肠道疾病发作病例，总体发病率为每10万名癌症患者52.5例，且在整个研究期间呈上升趋势。多因素分析显示，男性、低体重指数、淋巴细胞减少、血液系统恶性肿瘤、使用类固醇以及在CMV疾病发生前1个月内进行红细胞输血被确定为独立危险因素。在这些因素中，红细胞输血的优势比最高（OR = 5.09）。男性、低体重指数、淋巴细胞减少、血液系统恶性肿瘤、使用类固醇以及在CMV疾病诊断前1个月内进行红细胞输血是成年癌症患者发生CMV胃肠道疾病的独立危险因素。
