Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Dermatology. 2021;237(1):73-78. doi: 10.1159/000505911. Epub 2020 Feb 28.
It is well known that an immunosuppressed status such as cancer is a risk factor for herpes zoster (HZ), but little is known about whether HZ affects cancer development.
This study aimed to investigate the association between HZ and subsequent cancer risk by cancer type.
We conducted a nationwide retrospective cohort study using the Korean National Health Insurance claims database. The study enrolled 1,568,818 patients: 784,409 diagnosed with HZ between 2010 and 2015 were included in the HZ group, and 784,409 matched controls without HZ were included in the non-HZ group, with 1:1 exact matching for age, sex, and index year. Hazard ratios (HRs) were calculated for the risk of cancers based on anatomical site according to the HZ status using the Cox proportional hazards regression models.
During a mean follow-up period of 6 years, 22,235 and 22,316 patients in the HZ group and the non-HZ group, respectively, developed cancer (incidence rate: 7.6 vs. 7.7 per 1,000 person-years). After adjusting for age, sex, and comorbidities, the overall risk of cancers was slightly decreased in the HZ group compared with the non-HZ group (HR, 0.999; 95% confidence interval [CI], 0.98-1.02). In post hoc analyses on organ site, the HZ group had significantly increased risk of hematologic malignancies, including multiple myeloma (HR, 1.63; 95% CI, 1.37-1.95), leukemia (HR, 1.20; 95% CI, 1.03-1.39), and lymphoma (HR, 1.15; 95% CI, 1.02-1.30) compared with the non-HZ group. Conversely, the risk of cancers in the liver (HR, 0.87; 95% CI, 0.82-0.93) and larynx (HR, 0.73; 95% CI, 0.58-0.92) were significantly decreased in the HZ group compared with the non-HZ group.
Although the risk of developing some hematological cancers increased in patients with HZ, solid cancers including liver and laryngeal cancers showed a negative association with HZ.
众所周知，免疫抑制状态（如癌症）是带状疱疹（HZ）的危险因素，但对于 HZ 是否会影响癌症发展知之甚少。
本研究旨在按癌症类型探讨 HZ 与随后癌症风险之间的关联。
我们使用韩国国家健康保险索赔数据库进行了一项全国性回顾性队列研究。该研究纳入了 1568818 名患者：2010 年至 2015 年间诊断为 HZ 的 784409 名患者被纳入 HZ 组，784409 名匹配的无 HZ 对照组患者被纳入非 HZ 组，年龄、性别和索引年均进行 1:1 精确匹配。使用 Cox 比例风险回归模型根据 HZ 状态按解剖部位计算癌症风险的风险比（HRs）。
在平均 6 年的随访期间，HZ 组和非 HZ 组分别有 22235 名和 22316 名患者发生癌症（发病率：7.6 比 7.7/1000 人年）。在调整年龄、性别和合并症后，与非 HZ 组相比，HZ 组的总体癌症风险略有降低（HR，0.999；95%置信区间[CI]，0.98-1.02）。在器官部位的事后分析中，HZ 组发生血液恶性肿瘤（包括多发性骨髓瘤[HR，1.63；95%CI，1.37-1.95]、白血病[HR，1.20；95%CI，1.03-1.39]和淋巴瘤[HR，1.15；95%CI，1.02-1.30]）的风险显著增加。相比之下，与非 HZ 组相比，HZ 组癌症在肝脏（HR，0.87；95%CI，0.82-0.93）和喉（HR，0.73；95%CI，0.58-0.92）的风险显著降低。
尽管 HZ 患者发生某些血液恶性肿瘤的风险增加，但包括肝癌和喉癌在内的实体瘤与 HZ 呈负相关。
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