Kao Chia-Hong, Sun Li-Min, Chen Yueh-Sheng, Lin Cheng-Li, Liang Ji-An, Kao Chia-Hung, Weng Ming-Wei
From the Lab of Biomaterials, School of Chinese Medicine, China Medical University, Taichung (C-HK, Y-SC), Department of Chinese Medicine, Taipei Medical University Hospital, Taipei (C-HK), Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung (L-MS), Department of Bioinformatics and Medical Engineering, Asia University, Wufeng District, Taichung, Taiwan (Y-SC), Management Office for Health Data, China Medical University Hospital (C-LL), College of Medicine, China Medical University (C-LL), Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University (J-AL, C-HK), Department of Radiation Oncology, China Medical University Hospital (J-AL), Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung (C-HK); and Department of Internal Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan (M-WW).
Medicine (Baltimore). 2016 Jan;95(2):e2462. doi: 10.1097/MD.0000000000002462.
Little information is available regarding the risk of nongenitourinary (GU) cancers in patients with spinal cord injury (SCI). The authors conducted a nationwide population-based study to investigate whether a higher risk of non-GU cancer is seen among patients with SCI.Data retrieved from the National Health Insurance Research Database of Taiwan were used in this study. A total of 41,900 patients diagnosed with SCI between 2000 and 2011 were identified from the National Health Insurance Research Database and comprised the SCI cohort. Each of these patients was randomly frequency matched with 4 people from the general population (without SCI) according to age, sex, comorbidities, and index year. Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios and 95% confidence intervals and determine how SCI affected non-GU cancer risk.No significant difference in overall non-GU cancer risk was observed between the SCI and control groups. The patients with SCI exhibited a significantly higher risk of developing esophageal, liver, and hematologic malignancies compared with those without SCI. By contrast, the SCI cohort had a significantly lower risk of colorectal cancer compared with the non-SCI cohort (adjusted hazard ratio = 0.80, 95% confidence interval = 0.69-0.93). Additional stratified analyses by sex, age, and follow-up duration revealed various correlations between SCI and non-GU cancer risk.The patients with SCI exhibited higher risk of esophageal, liver, and hematologic malignancies but a lower risk of colorectal cancer compared with those without SCI. The diverse patterns of cancer risk among the patients with SCI may be related to the complications of chronic SCI.
关于脊髓损伤（SCI）患者发生非泌尿生殖系统（GU）癌症的风险，目前可用信息较少。作者进行了一项基于全国人口的研究，以调查SCI患者中是否存在较高的非GU癌症风险。本研究使用了从台湾国民健康保险研究数据库中检索到的数据。从国民健康保险研究数据库中识别出2000年至2011年间共41900例被诊断为SCI的患者，组成SCI队列。根据年龄、性别、合并症和索引年份，将这些患者中的每一位与4名普通人群（无SCI）进行随机频率匹配。使用Cox比例风险回归分析来计算调整后的风险比和95%置信区间，并确定SCI如何影响非GU癌症风险。在SCI组和对照组之间，未观察到总体非GU癌症风险的显著差异。与无SCI的患者相比，SCI患者发生食管癌、肝癌和血液系统恶性肿瘤的风险显著更高。相比之下，与非SCI队列相比，SCI队列患结直肠癌的风险显著更低（调整后的风险比=0.80，95%置信区间=0.69-0.93）。按性别、年龄和随访时间进行的额外分层分析揭示了SCI与非GU癌症风险之间的各种相关性。与无SCI的患者相比，SCI患者发生食管癌、肝癌和血液系统恶性肿瘤的风险更高，但患结直肠癌的风险更低。SCI患者中不同的癌症风险模式可能与慢性SCI的并发症有关。
