Division of Nephrology, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Artificial Intelligence and Big-Data Convergence Centre, Gil Medical Centre, Gachon University College of Medicine, Incheon, Korea.
Int J Infect Dis. 2021 Dec;113:127-135. doi: 10.1016/j.ijid.2021.10.014. Epub 2021 Oct 12.
To investigate the risk of haematologic and solid organ malignancies in patients with haemorrhagic fever with renal syndrome (HFRS) compared with the general population.
This propensity-score-matched cohort study was conducted using data collected from the Korean national health insurance service (NHIS) between January 2003 and December 2017. The HFRS cohort included 5888 newly diagnosed cases of HFRS, and 412,804 general participants from the NHIS database were included as the control cohort. The incidence rate of malignancies was assessed and compared between the HFRS and control cohorts.
There were 64 cases of haematologic malignancy in 236,286 person-years of observation, and 1245 cases of solid organ cancer in 209,333 person-years. The risks of haematologic malignancy and solid organ cancer were significantly higher in the HFRS cohort [adjusted hazards ratio (aHR) 4.10, 95% confidence interval (CI) 2.36-7.14] than the control cohort [aHR 2.97, 95% CI 2.60-3.38). In subgroup analysis, the HFRS cohort was associated with high hazard ratios for leukaemia and non-Hodgkin lymphoma. The HFRS cohort also had increased aHRs for all types of solid organ cancer.
Patients with HFRS are at increased risk of both haematologic and solid organ malignancies compared with the general population, and this increased proportionally over time. Careful monitoring for malignancy after the onset of HFRS may be necessary.
与普通人群相比,调查肾综合征出血热(HFRS)患者发生血液系统和实体器官恶性肿瘤的风险。
本倾向评分匹配队列研究使用了 2003 年 1 月至 2017 年 12 月期间从韩国国家健康保险服务(NHIS)收集的数据进行。HFRS 队列包括 5888 例新诊断的 HFRS 病例,NHIS 数据库中包含 412804 例一般参与者作为对照队列。评估并比较了 HFRS 队列和对照队列中恶性肿瘤的发病率。
在 236286 人年的观察期间,有 64 例血液系统恶性肿瘤病例,209333 人年中有 1245 例实体器官癌病例。HFRS 队列中血液系统恶性肿瘤和实体器官癌的风险明显高于对照组[调整后的危险比(aHR)4.10,95%置信区间(CI)2.36-7.14] [aHR 2.97,95% CI 2.60-3.38)。亚组分析显示,HFRS 队列与白血病和非霍奇金淋巴瘤的高危险比相关。HFRS 队列也与所有类型的实体器官癌的 aHR 增加相关。
与普通人群相比,HFRS 患者发生血液系统和实体器官恶性肿瘤的风险增加,且随着时间的推移呈比例增加。HFRS 发病后可能需要对恶性肿瘤进行仔细监测。