支气管扩张症患者肺癌风险增加：一项全国性队列研究。

Increased risk of lung cancer among patients with bronchiectasis: a nationwide cohort study.

机构信息

From the Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Department of Health Services Administration, China Medical University, Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung.

Management Office for Health Data, China Medical University Hospital, Taichung, College of Medicine, China Medical University, Taichung.

出版信息

QJM. 2016 Jan;109(1):17-25. doi: 10.1093/qjmed/hcu237. Epub 2014 Nov 29.

DOI:10.1093/qjmed/hcu237

PMID:25435548

Abstract

BACKGROUND

We conducted a longitudinal nationwide cohort study in Taiwan to determine whether patients with bronchiectasis are at an increased risk of developing lung cancer.

METHODS

This study investigated the incidence and risk for lung cancer in 57 576 patients newly hospitalized with bronchiectasis between 1998 and 2010 from the Taiwan National Health Insurance Research Database. The comparison cohort comprised 230 304 individuals from the general population without bronchiectasis. The follow-up period was from the time of the initial hospitalization for bronchiectasis to the date of a lung cancer diagnosis, censoring, or 31 December 2011. We used Cox proportional hazard regression models to analyse the risk of lung cancer by including the variables of sex, age and comorbidities.

RESULTS

The incidence of lung cancer was higher in patients with bronchiectasis than in the comparison cohort (4.58 vs. 2.02 per 1000 person-years). The bronchiectasis patients exhibited a 2.36-fold increased risk of lung cancer compared with the comparison cohort after adjustment for age, sex and comorbidities (adjusted hazard ratio [aHR] = 2.36, 95% confidence interval [CI] = 2.19-2.55). The sex-specific bronchiectasis cohort to comparison cohort revealed that the aHR was 2.41 (95% CI = 2.11-2.76) for the women and 2.33 (95% CI = 2.12-2.56) for the men. The incidence rate of lung cancer increased as age increased in both cohorts.

CONCLUSION

This nationwide study determined that the patients with bronchiectasis exhibited an increased risk of lung cancer compared with the general population.

摘要

背景

我们在台湾进行了一项纵向全国队列研究，以确定支气管扩张症患者是否患肺癌的风险增加。

方法

本研究调查了 1998 年至 2010 年间从台湾全民健康保险研究数据库中因支气管扩张症新住院的 57576 例患者的肺癌发病率和风险。对照组由 230304 名无支气管扩张症的普通人群个体组成。随访期为支气管扩张症首次住院至肺癌诊断、截止或 2011 年 12 月 31 日的时间。我们使用 Cox 比例风险回归模型分析了肺癌的风险，包括性别、年龄和合并症等变量。

结果

支气管扩张症患者的肺癌发病率高于对照组（4.58 比 2.02 每 1000 人年）。在调整年龄、性别和合并症后，支气管扩张症患者的肺癌风险比对照组增加 2.36 倍（调整后危险比[aHR]=2.36，95%置信区间[CI]：2.19-2.55）。支气管扩张症患者按性别分层与对照组相比，女性的 aHR 为 2.41（95%CI：2.11-2.76），男性为 2.33（95%CI：2.12-2.56）。两个队列的肺癌发病率均随年龄增长而增加。