Bonifazi Martina, Bravi Francesca, Gasparini Stefano, La Vecchia Carlo, Gabrielli Armando, Wells Athol U, Renzoni Elisabetta A
Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri-Istituto di Ricovero e Cura a carattere Scientifico, Milan, Italy.
Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy.
Chest. 2015 Mar;147(3):778-791. doi: 10.1378/chest.14-1475.
An increased cancer risk in patients with sarcoidosis has been suggested, although results are conflicting in a number of case-control and cohort studies. We conducted a systematic review of all available data and performed a meta-analysis to better define and quantify the association between sarcoidosis and cancer.
We searched Medline and Embase for all original articles on cancer and sarcoidosis published up to January 2013. Two independent authors reviewed all titles/abstracts to identify studies according to predefined selection criteria. We derived summary estimates using a random-effects model and reported them as relative risk (RR). Publication bias was evaluated using a funnel plot and was quantified by the Egger test.
Sixteen original studies, involving > 25,000 patients, were included in the present review. The summary RR to develop all invasive cancers was 1.19 (95% CI, 1.07-1.32). The results for selected cancer sites indicated a significantly increased risk of skin (RR, 2.00; 95% CI, 1.69-2.36), hematopoietic (RR, 1.92; 95% CI, 1.41-2.62), upper digestive tract (RR, 1.73; 95% CI, 1.07-2.79), kidney (RR, 1.55; 95% CI, 1.21-1.99), liver (RR, 1.79; 95% CI, 1.03-3.11), and colorectal cancers (RR, 1.33; 95% CI, 1.07-1.67). There was no evidence of publication bias for all cancers (P = .9), nor for any specific cancer site.
The present meta-analysis suggests a significant, though moderate, association between sarcoidosis and malignancy.
结节病患者患癌风险增加，尽管多项病例对照研究和队列研究结果相互矛盾。我们对所有可用数据进行了系统综述，并进行了荟萃分析，以更好地定义和量化结节病与癌症之间的关联。
我们检索了截至2013年1月发表的关于癌症和结节病的所有原始文章。两名独立作者根据预定义的选择标准对所有标题/摘要进行审查，以确定研究。我们使用随机效应模型得出汇总估计值，并将其报告为相对风险（RR）。使用漏斗图评估发表偏倚，并通过Egger检验进行量化。
本综述纳入了16项涉及超过25000名患者的原始研究。患所有侵袭性癌症的汇总RR为1.19（95%CI，1.07-1.32）。选定癌症部位的结果表明，皮肤癌（RR，2.00；95%CI，1.69-2.36）、血液系统癌症（RR，1.92；95%CI，1.41-2.62）、上消化道癌（RR，1.73；95%CI，1.07-2.79）、肾癌（RR，1.55；95%CI，1.21-1.99）、肝癌（RR，1.79；95%CI，1.03-3.11）和结直肠癌（RR，1.33；95%CI，1.07-1.67）的风险显著增加。所有癌症以及任何特定癌症部位均无发表偏倚的证据（P =.9）。
本荟萃分析表明，结节病与恶性肿瘤之间存在显著但中等程度的关联。
