Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Am J Gastroenterol. 2022 Jan 1;117(1):129-137. doi: 10.14309/ajg.0000000000001525.
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease and as such may increase the risk of cancer. We examined cancer risks in a nationwide cohort of patients with AIH.
This study was based on nationwide Danish healthcare registries. We identified all persons diagnosed with AIH between 1994 and 2018. We included 1805 patients with AIH and 16,617 age- and sex-matched population controls. We estimated cumulative risks of cancers and risk ratios (RRs) between patients and controls. Within the cohort of patients with AIH, we examined the impact of immunosuppressive treatment (IST) and cirrhosis on cancer risks.
The 10-year risk of any cancer was 13.6% (95% confidence interval [CI] 11.7-15.6) in patients with AIH with an RR of 1.5 (95% CI 1.3-1.7) compared with controls. Patients with AIH had a 10-year risk of 0.5% (95% CI 0.2-1.1) for hepatocellular carcinoma. The 10-year risk was 1.6% (95% CI 1.0-2.5) for colorectal cancer (RR: 2.1 [95% CI 1.3-3.5]) and 4.0% (95% CI 3.0-5.3) for nonmelanoma skin cancer (RR: 1.8 [95% CI 1.3-2.5]). Among patients with AIH, the risk of cancer was higher for those with cirrhosis (hazard ratio: 1.3 [95% CI 1.0-1.7]), and it also increased 1.05-fold (95% CI 1.0-1.1) for every year the patient was on IST.
AIH was associated with a 1.5-fold increased 10-year risk of cancer compared with age- and sex-matched controls. Among patients with AIH, the risk of cancer was higher for those with cirrhosis, and it also increased slightly with longer duration of IST.
自身免疫性肝炎（AIH）是一种慢性炎症性肝病，因此可能会增加癌症风险。我们在一项全国性 AIH 患者队列中研究了癌症风险。
本研究基于全国丹麦医疗保健登记处。我们确定了 1994 年至 2018 年间诊断为 AIH 的所有患者。我们纳入了 1805 名 AIH 患者和 16617 名年龄和性别匹配的人群对照。我们估计了癌症的累积风险和患者与对照之间的风险比（RR）。在 AIH 患者队列中，我们检查了免疫抑制治疗（IST）和肝硬化对癌症风险的影响。
AIH 患者的 10 年任何癌症风险为 13.6%（95%置信区间[CI]11.7-15.6），RR 为 1.5（95%CI1.3-1.7），与对照组相比。AIH 患者的肝细胞癌 10 年风险为 0.5%（95%CI0.2-1.1）。结直肠癌的 10 年风险为 1.6%（95%CI1.3-2.5）（RR：2.1[95%CI1.3-3.5]），非黑色素瘤皮肤癌的 10 年风险为 4.0%（95%CI3.0-5.3）（RR：1.8[95%CI1.3-2.5]）。在 AIH 患者中，肝硬化患者的癌症风险更高（风险比：1.3[95%CI1.0-1.7]），并且 IST 患者每增加 1 年，风险增加 1.05 倍（95%CI1.0-1.1）。
与年龄和性别匹配的对照组相比，AIH 患者的 10 年癌症风险增加了 1.5 倍。在 AIH 患者中，肝硬化患者的癌症风险更高，并且随着 IST 持续时间的延长，癌症风险也略有增加。
