Lucariello Richard J, Villablanca Salvadore E, Mascaró José M, Reichel Martin
School of Medicine, New York Medical College, Valhalla, New York, USA.
Dr Gustavo Fricke Hospital, Vina del Mar, Chile.
Australas J Dermatol. 2018 Nov;59(4):253-260. doi: 10.1111/ajd.12764. Epub 2018 Jan 4.
It has been suggested that bullous pemphigoid is associated with an increased risk of malignancy, but the evidence is inconsistent. Therefore, a meta-analysis was conducted to explore this association. PUBMED and Embase were searched for studies investigating the association between bullous pemphigoid and malignancy. This meta-analysis included 16 studies with a total of 9398 cases of bullous pemphigoid. The rate of malignancy in patients with bullous pemphigoid was 11% (95% CI: 9-14, P < 0.001); 9% (95% CI: 6-13, P < 0.003) for women and 13% (95% CI: 9-18, P < 0.03) for men, with a statistically insignificant higher risk in men (OR = 1.30, 95% CI: 0.99-1.71, P = 0.06). The event rate was 9% (95% CI: 5-14, P < 0.001) in the Asian population and 13% (95% CI: 10-17, P < 0.001) in the European population, with a statistically significant lower risk in the Asians population (OR = 0.69, 95% CI: 0.57-0.84; P < 0.001). The event rate of malignancy was higher in patients with bullous pemphigoid than in matched controls (OR = 2.08, 95% CI: 1.22-3.55; P = 0.005). The overall event rate of malignancy was higher in the bullous pemphigoid group than in matched controls. Caution is required when interpreting these results, as potential confounding variables were not controlled for.
有人提出大疱性类天疱疮与恶性肿瘤风险增加有关,但证据并不一致。因此,进行了一项荟萃分析以探讨这种关联。检索了PUBMED和Embase数据库中调查大疱性类天疱疮与恶性肿瘤之间关联的研究。该荟萃分析纳入了16项研究,共9398例大疱性类天疱疮病例。大疱性类天疱疮患者的恶性肿瘤发生率为11%(95%可信区间:9-14,P<0.001);女性为9%(95%可信区间:6-13,P<0.003),男性为13%(95%可信区间:9-18,P<0.03),男性风险略高但无统计学意义(OR=1.30,95%可信区间:0.99-1.71,P=0.06)。亚洲人群的事件发生率为9%(95%可信区间:5-14,P<0.001),欧洲人群为13%(95%可信区间:10-17,P<0.001),亚洲人群风险显著较低(OR=0.69,95%可信区间:0.57-0.84;P<0.001)。大疱性类天疱疮患者的恶性肿瘤事件发生率高于匹配对照组(OR=2.08,95%可信区间:1.22-3.55;P=0.005)。大疱性类天疱疮组的总体恶性肿瘤事件发生率高于匹配对照组。由于未控制潜在的混杂变量,在解释这些结果时需要谨慎。