Chen Chien-Hua, Chen Chung-Hung, Lin Cheng-Li, Hsu Chung Y, Kao Chia-Hung
Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang Township, Changhua County.
Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua.
Ann Transl Med. 2020 Mar;8(5):213. doi: 10.21037/atm.2020.01.40.
To evaluate the relation of head and neck cancer to chronic pancreatitis by analyzing Taiwan's National Health Insurance Research Database.
We identified 11,237 patients with chronic pancreatitis as the case cohort, which was propensity score matched with another 11,237 patients without chronic pancreatitis by sex, age, index year, and comorbidities. We followed both cohorts between January 1, 2000, and December 31, 2011 to measure the incidence of head and neck cancer.
Compared with patients without chronic pancreatitis, those with chronic pancreatitis were associated a greater risk of head and neck cancer [adjusted HR (aHR) =1.31, 95% confidence interval (CI): 1.07-1.60] and had a higher incidence of head and neck cancer (log-rank test, P<0.001). The experimental event rate of head and neck cancer for the chronic pancreatitis cohort was 1.90% (213/11,237) and control event rate of head and neck cancer for the non-chronic pancreatitis cohort was 1.60% (180/11,237), respectively. Therefore, the chronic pancreatitis cohort had a 0.30% of absolute risk increase and approximately 333 of number needed to harm for the development of head and neck cancer, respectively. Compared with the individuals without chronic pancreatitis and any other comorbidity, the risk of head and neck cancer for the chronic pancreatitis patients without comorbidities was 2.79 folds and the risk increased to 4.32, 3.33, 3.22, 4.44, and 5.78 folds in the presence of any one, any two, any three, any four, and more than five comorbidities, respectively.
Chronic pancreatitis is related to an increased risk of head and neck cancer, and the presence of comorbidity increases the risk more. It requires more studies to find more co-existing risk factors or comorbidities to recommend a screening program for the CP patients. Moreover, it needs more studies to ascertain the pathogenesis for the aforementioned association and the limited knowledge of the patients' smoking habits and alcohol drinking is the major limitation of this observational study.
通过分析台湾地区国民健康保险研究数据库，评估头颈癌与慢性胰腺炎之间的关系。
我们将11237例慢性胰腺炎患者确定为病例队列，并根据性别、年龄、索引年份和合并症，将其与另外11237例无慢性胰腺炎的患者进行倾向评分匹配。我们在2000年1月1日至2011年12月31日期间对两个队列进行随访，以测量头颈癌的发病率。
与无慢性胰腺炎的患者相比，慢性胰腺炎患者患头颈癌的风险更高[校正风险比（aHR）=1.31，95%置信区间（CI）：1.07 - 1.60]，且头颈癌发病率更高（对数秩检验，P<0.001）。慢性胰腺炎队列中头颈癌的实验事件率为1.90%（213/11237），非慢性胰腺炎队列中头颈癌的对照事件率为1.60%（180/11237）。因此，慢性胰腺炎队列发生头颈癌的绝对风险增加了0.30%，且造成伤害所需的病例数约为333例。与无慢性胰腺炎且无任何其他合并症的个体相比，无合并症的慢性胰腺炎患者患头颈癌的风险为2.79倍，在存在任何一种、任何两种、任何三种、任何四种以及五种以上合并症时，风险分别增加到4.32倍、3.33倍、3.22倍、4.44倍和5.78倍。
慢性胰腺炎与头颈癌风险增加有关，合并症的存在会进一步增加风险。需要更多研究来发现更多共存的风险因素或合并症，以便为慢性胰腺炎患者推荐筛查方案。此外，需要更多研究来确定上述关联的发病机制，而对患者吸烟习惯和饮酒情况了解有限是本观察性研究的主要局限性。
