白塞病患者发生总体癌症及特定部位癌症的风险：台湾一项基于全国人口的研究
Risk of Overall and Site-specific Cancers in Behçet Disease: A Nationwide Population-based Study in Taiwan.
作者信息
Wang Li-Hui, Wang Wei-Ming, Hsu Sheng-Min, Lin Sheng-Hsiang, Shieh Chi-Chang
机构信息
From the Institute of Clinical Medicine, College of Medicine, National Cheng Kung University; Division of Immunology, Department of Pediatrics, Kuo General Hospital; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, and Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan.L.H. Wang, MD, Immunologist, Division of Immunology, Department of Pediatrics, Kuo General Hospital; W.M. Wang, MS, Biostatistician, Clinical Research Center; S.M. Hsu, MD, PhD, Ophthalmologist, Department of Ophthalmology, National Cheng Kung University Hospital; S.H. Lin, PhD, Assistant Professor of Biostatistics, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University; C.C. Shieh, MD, PhD, Professor of Immunology, Rheumatology and Pediatrics, Institute of Clinical Medicine, National Cheng Kung University, and Division of Allergy, Immunology and Rheumatology, and Department of Pediatrics, National Cheng Kung University Hospital.
出版信息
J Rheumatol. 2015 May;42(5):879-84. doi: 10.3899/jrheum.140770. Epub 2015 Apr 1.
OBJECTIVE
The relationship between autoimmune disease and cancer is complex while large-scale epidemiological studies of cancer risk in Behçet disease (BD) have not been reported. Therefore, we conducted a nationwide population-based cohort study.
METHODS
By using the National Health Insurance Research Database of 23 million people in Taiwan, we identified 1314 new patients with BD without previous cancer from 2000-2009 as a cohort. Standardized incidence ratios (SIR) of overall and site-specific cancers in patients with BD in comparison with the general population were calculated from 2000-2011.
RESULTS
Among the 1314 patients with BD, 30 developed cancers (9 men and 21 women). In overall cancer risk analysis, patients with BD had a higher risk (SIR 1.5, 95% CI 1.03-2.11). Among them, female patients with BD (SIR 1.8, 95% CI 1.14-2.7), but not male patients with BD (SIR 1.08, 95% CI 0.53-1.98), have a higher risk of overall cancer. In site-specific cancer risk analysis, patients with BD had a higher risk of non-Hodgkin lymphoma (SIR 8.3, 95% CI 2.1-22.7), hematological malignancy (SIR 4.2, 95% CI 1.3-10.2), and female breast cancer (SIR 2.2, 95% CI 1.004-4.1). The cancer risk was highest within the first-year followup (SIR 2.7, 95% CI 1.3-5.1), with 75% of the hematological malignancies found within the first year.
CONCLUSION
This nationwide cohort study of cancer risk in patients with BD provides important information about the relationship between BD and malignancies. The results can be useful for cancer surveys in the future.
目的
自身免疫性疾病与癌症之间的关系较为复杂，而关于白塞病（BD）患者癌症风险的大规模流行病学研究尚未见报道。因此，我们开展了一项基于全国人群的队列研究。
方法
利用台湾地区2300万人的国民健康保险研究数据库，我们确定了2000年至2009年间1314例既往无癌症的BD新发病例作为一个队列。计算了2000年至2011年间BD患者总体及特定部位癌症的标准化发病比（SIR），并与普通人群进行比较。
结果
在1314例BD患者中，30例发生了癌症（9例男性和21例女性）。在总体癌症风险分析中，BD患者风险更高（SIR 1.5，95%CI 1.03 - 2.11）。其中，BD女性患者（SIR 1.8，95%CI 1.14 - 2.7）总体癌症风险较高，而BD男性患者（SIR 1.08，95%CI 0.53 - 1.98）并非如此。在特定部位癌症风险分析中，BD患者非霍奇金淋巴瘤风险较高（SIR 8.3，95%CI 2.1 - 22.7）、血液系统恶性肿瘤风险较高（SIR 4.2，95%CI 1.3 - 10.2）以及女性乳腺癌风险较高（SIR 2.2，95%CI 1.004 - 4.1）。癌症风险在随访的第一年最高（SIR 2.7，95%CI 1.3 - 5.1），75%的血液系统恶性肿瘤在第一年被发现。
结论
这项关于BD患者癌症风险的全国性队列研究提供了有关BD与恶性肿瘤关系的重要信息。研究结果对未来的癌症调查可能有用。
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