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韩国患者炎症性肠病早期的癌症风险:一项全国基于人群的研究。

Cancer Risk in the Early Stages of Inflammatory Bowel Disease in Korean Patients: A Nationwide Population-based Study.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.

出版信息

J Crohns Colitis. 2017 Aug 1;11(8):954-962. doi: 10.1093/ecco-jcc/jjx040.

Abstract

BACKGROUND AND AIMS

The association between inflammatory bowel disease [IBD] and cancer remains poorly defined in Asian populations. Therefore, we conducted a nationwide population-based study to determine the cancer risk in Korean patients with IBD.

METHODS

Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD (5595 Crohn's disease [CD] and 10 049 ulcerative colitis [UC]) from 2011 to 2014. Standardized incidence ratios [SIRs] of overall and site-specific cancers in IBD patients in comparison with the general population were calculated.

RESULTS

The overall cancer risk was higher in CD patients [SIR, 2.2; 95% confidence interval, 1.5-3.0 in men and 3.3; 2.4-4.5 in women] and UC patients [1.9; 1.6-2.3 in men and 1.9; 1.5-2.4 in women]. There were significantly increased risks for the following cancers: small bowel cancer [31.2; 3.8-112.8], colorectal cancer [CRC] [3.7; 1.6-7.2] and haematological cancer [4.0; 1.1-10.3] in men with CD; small bowel cancer [61.1; 7.4-220.6], CRC [4.7; 1.5-10.9], liver cancer [15.3; 5.6-33.2], pancreatic cancer [8.6; 1.0-31.0] and haematological cancer [11.0; 3.6-25.7] in women with CD; CRC [2.1; 1.3-3.3] and cancer of the prostate [3.5; 2.1-5.5], brain/central nervous system [6.1; 1.3-17.9] and thyroid [2.2; 1.1-3.9] in men with UC; and CRC [3.0; 1.5-5.3], cancer of the liver [4.4; 1.6-9.7] and cervix uteri [5.7; 2.4-11.1], and haematological cancer [3.5; 1.1-8.1] in women with UC. Women with CD had an increased risk of non-Hodgkin lymphoma [NHL] and leukaemia. Women with UC had an increased risk of NHL.

CONCLUSIONS

Korean patients with IBD are at increased risk for overall, intestinal and haematological cancer.

摘要

背景和目的

炎症性肠病(IBD)与癌症之间的关联在亚洲人群中仍未得到明确界定。因此,我们进行了一项全国性的基于人群的研究,以确定韩国 IBD 患者的癌症风险。

方法

使用国家健康保险索赔数据,我们收集了 2011 年至 2014 年间诊断为 IBD(5595 例克罗恩病 [CD] 和 10049 例溃疡性结肠炎 [UC])的患者数据。计算 IBD 患者的总体和特定部位癌症的标准化发病比(SIR),并与一般人群进行比较。

结果

CD 患者的总体癌症风险较高[SIR,2.2;95%置信区间,男性为 1.5-3.0,女性为 3.3;2.4-4.5]和 UC 患者[SIR,1.9;1.6-2.3男性和 1.9;1.5-2.4女性]。男性 CD 患者的以下癌症风险显著增加:小肠癌[31.2;3.8-112.8]、结直肠癌[CRC] [3.7;1.6-7.2]和血液癌[4.0;1.1-10.3];女性 CD 患者的小肠癌[61.1;7.4-220.6]、CRC [4.7;1.5-10.9]、肝癌[15.3;5.6-33.2]、胰腺癌[8.6;1.0-31.0]和血液癌[11.0;3.6-25.7];男性 UC 患者的 CRC [2.1;1.3-3.3]和前列腺癌[3.5;2.1-5.5]、脑/中枢神经系统[6.1;1.3-17.9]和甲状腺[2.2;1.1-3.9];女性 UC 患者的 CRC [3.0;1.5-5.3]、肝癌[4.4;1.6-9.7]和子宫颈[5.7;2.4-11.1]和血液癌[3.5;1.1-8.1]。CD 女性患者患非霍奇金淋巴瘤(NHL)和白血病的风险增加。UC 女性患者患 NHL 的风险增加。

结论

韩国 IBD 患者患总体癌症、肠道癌和血液癌的风险增加。

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