Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.
State Key Laboratory of Respiratory Disease, Guangzhou, 510120, China.
J Cancer Res Clin Oncol. 2020 Aug;146(8):1933-1940. doi: 10.1007/s00432-020-03245-3. Epub 2020 May 27.
Few studies have investigated the relationship between vitiligo and risks of various types of cancers, especially those other than skin cancer. Conventional observational studies are susceptible to potential confounders and inverse causation. With a Mendelian randomization approach, we were able to evaluate the causality between vitiligo and different cancer risks.
37 vitiligo-related single-nucleotide polymorphisms identified by the published genome-wide association studies were used as instrumental variables in our study. Summary data of individual-level genetic information were obtained from corresponding studies and cancer consortia. A total of 246,706 cases and 1,021,154 controls were included. The inverse variance-weighted method was applied to estimate the causation between vitiligo and different cancers.
The results revealed that vitiligo patients were at lower risks of lung cancer [odds ratio (OR) 0.9513; 95% confidence interval (CI) 0.9174-0.9864; p = 0.0070], breast cancer (OR 0.9827; 95% CI 0.9659-0.9997; p = 0.0468), ovarian cancer (OR 0.9474; 95% CI 0.9271-0.9682; p < 0.001), melanoma (OR 0.9983; 95% CI 0.9976-0.9990; p < 0.001), non-melanoma skin cancer (OR 0.9997; 95% CI 0.9995-0.9999; p < 0.001), kidney cancer (OR 0.9998; 95% CI 0.9996-1.0000; p = 0.0212), and liver cancer (OR 0.9999; 95% CI 0.9999-1.0000; p = 0.0441), while no correlation was observed for other cancer types.
Vitiligo was causally associated with reduced risks of several cancers, suggesting that vitiligo-associated autoimmune process might play a role in the suppression of cancer.
很少有研究调查白癜风与各种类型癌症（尤其是非皮肤癌）风险之间的关系。传统的观察性研究易受潜在混杂因素和反向因果关系的影响。通过孟德尔随机化方法，我们能够评估白癜风与不同癌症风险之间的因果关系。
使用已发表的全基因组关联研究确定的 37 个白癜风相关单核苷酸多态性作为本研究的工具变量。个体水平遗传信息的汇总数据来自相应的研究和癌症联盟。共纳入 246706 例病例和 1021154 例对照。应用逆方差加权法估计白癜风与不同癌症之间的因果关系。
结果显示，白癜风患者肺癌（比值比[OR] 0.9513；95%置信区间[CI] 0.9174-0.9864；p=0.0070）、乳腺癌（OR 0.9827；95%CI 0.9659-0.9997；p=0.0468）、卵巢癌（OR 0.9474；95%CI 0.9271-0.9682；p<0.001）、黑色素瘤（OR 0.9983；95%CI 0.9976-0.9990；p<0.001）、非黑色素瘤皮肤癌（OR 0.9997；95%CI 0.9995-0.9999；p<0.001）、肾癌（OR 0.9998；95%CI 0.9996-1.0000；p=0.0212）和肝癌（OR 0.9999；95%CI 0.9999-1.0000；p=0.0441）的风险降低，而其他癌症类型则没有相关性。
白癜风与几种癌症风险降低存在因果关系，表明白癜风相关的自身免疫过程可能在抑制癌症方面发挥作用。
