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常见可变免疫缺陷中的恶性肿瘤:系统评价和荟萃分析。

Malignancy in common variable immunodeficiency: a systematic review and meta-analysis.

机构信息

Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran , Iran.

Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences , Tehran , Iran.

出版信息

Expert Rev Clin Immunol. 2019 Oct;15(10):1105-1113. doi: 10.1080/1744666X.2019.1658523. Epub 2019 Sep 15.

Abstract

: Common variable immunodeficiency (CVID) is the most common clinically significant primary immunodeficiency (PID) disorder characterized by variable clinical manifestations including recurrent infections, autoimmune disorders, enteropathy, lymphoproliferative disorders, and malignancy. The aim of this study is to estimate the overall prevalence of malignancy in patients with CVID. : PubMed, Web of Science and Scopus were searched systemically to find eligible studies from the earliest available date to March 2019 with standard keywords. Pooled estimates of the malignancy prevalence and the corresponding 95% confidence intervals (CI) were calculated using random effects models. : Forty-eight studies with a total of 8123 CVID patients met the inclusion criteria and were finally included in the meta-analysis. Overall prevalence of malignancy was 8.6% (95% CI: 7.1-10.0; I = 79.2%). The prevalence of lymphoma, gastric cancer, and breast cancer in CVID patients were 4.1% (95% CI: 3.3-4.9; I = 62.6%), 1.5% (95% CI: 0.78-2.2; I = 68.9%), and 1.3% (95% CI: 0.64-1.9; I = 54.9%), respectively. Moreover, autoimmunity and malabsorption were more frequent in patients with malignancy than those without malignancy. : The prevalence of malignancy has increased in CVID patients due to recent improvement in survival rate and the lymphoma is the most common type. This research highlighted the significance of malignancy screening and management in CVID patients.

摘要

普通变异性免疫缺陷(CVID)是最常见的临床显著原发性免疫缺陷(PID)疾病,其特征是临床表现多样,包括反复感染、自身免疫性疾病、肠病、淋巴增生性疾病和恶性肿瘤。本研究旨在评估 CVID 患者恶性肿瘤的总体患病率。

从最早的可用日期到 2019 年 3 月,我们通过系统地在 PubMed、Web of Science 和 Scopus 上搜索,使用标准关键词查找符合条件的研究。使用随机效应模型计算恶性肿瘤患病率和相应的 95%置信区间(CI)的汇总估计值。

符合纳入标准的 48 项研究共有 8123 例 CVID 患者最终纳入荟萃分析。恶性肿瘤的总患病率为 8.6%(95%CI:7.1-10.0;I = 79.2%)。CVID 患者淋巴瘤、胃癌和乳腺癌的患病率分别为 4.1%(95%CI:3.3-4.9;I = 62.6%)、1.5%(95%CI:0.78-2.2;I = 68.9%)和 1.3%(95%CI:0.64-1.9;I = 54.9%)。此外,恶性肿瘤患者比无恶性肿瘤患者更常发生自身免疫和吸收不良。

由于生存率的提高,CVID 患者恶性肿瘤的患病率有所增加,而淋巴瘤是最常见的类型。这项研究强调了对 CVID 患者进行恶性肿瘤筛查和管理的重要性。

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