非酒精性脂肪性肝病患者的肿瘤发病率。
Tumor Incidence in Patients with Non-Alcoholic Fatty Liver Disease.
机构信息
Department of Medicine I, University Medical Center MainzMetabolic Liver Diseases, Department of Medicine I, University Medical Center MainzEpidemiology, IQVIA, Frankfurt.
出版信息
Dtsch Arztebl Int. 2020 Oct 23;117(43):719-724. doi: 10.3238/arztebl.2020.0719.
BACKGROUND
The incidence of cancer is increasing worldwide. The role of comorbidities in this development is debated. The aim of this study was to investigate the significance of non-alcoholic fatty liver disease (NAFLD) for the incidence of cancer of various kinds in Germany.
METHODS
Between 2000 and 2015, data on 31 587 patients with established NAFLD were collected for analysis. A control group (n = 31 587) assembled for comparison was matched for sex, age, treating physician, and Charlson Comorbidity Index (CCI).
RESULTS
By 10 years after the index date, 15.3% of patients with NAFLD and 13.4% of patients in the control group had been diagnosed with cancer (p <0.001). Patients with NAFLD exhibited significantly higher rates of male genital cancers (HR 1.26; 95% confidence interval [1.06; 1.5]; p = 0.008), skin cancer (HR 1.22 [1.07; 1.38]; p = 0.002) and breast cancer (HR 1.2 [1.01; 1.43]; p = 0.036). In this analysis, the rate of hepatocellular carcinoma did not differ between patients with NAFLD and patients without NAFLD (0.19% vs. 0.12%; p = 0.204).
CONCLUSION
NAFLD slightly increases the risk of breast cancer in women, genital cancer in men, and skin cancer irrespective of sex. Thus, NAFLD can be considered a marker of increased cancer risk.
背景
全球癌症发病率正在上升。合并症在此发展过程中的作用存在争议。本研究旨在调查非酒精性脂肪性肝病（NAFLD）对德国各种癌症发病率的意义。
方法
在 2000 年至 2015 年间，共收集了 31587 例确诊为 NAFLD 的患者数据进行分析。为了进行比较，还为每位患者匹配了一个对照组（n=31587），对照组的性别、年龄、治疗医生和 Charlson 合并症指数（CCI）与病例组相匹配。
结果
在索引日期后的 10 年内，NAFLD 患者中有 15.3%和对照组中有 13.4%的患者被诊断患有癌症（p<0.001）。NAFLD 患者的男性生殖器癌症（HR 1.26；95%置信区间 [1.06；1.5]；p=0.008）、皮肤癌（HR 1.22 [1.07；1.38]；p=0.002）和乳腺癌（HR 1.2 [1.01；1.43]；p=0.036）的发病率明显更高。在本分析中，NAFLD 患者与无 NAFLD 患者的肝细胞癌发生率没有差异（0.19% vs. 0.12%；p=0.204）。
结论
NAFLD 略微增加了女性乳腺癌、男性生殖器癌症和无论性别如何的皮肤癌的风险。因此，NAFLD 可以被视为癌症风险增加的标志物。
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