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肺动脉高压与癌症诊断发病率的增加有关。

Pulmonary hypertension is associated with an increased incidence of cancer diagnoses.

作者信息

Roderburg Christoph, Loosen Sven H, Hippe Hans-Joerg, Luedde Tom, Kostev Karel, Luedde Mark

机构信息

Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf Medical Faculty of Heinrich Heine University Düsseldorf Düsseldorf Germany.

Department of Cardiology Marien-Hospital Witten Witten Germany.

出版信息

Pulm Circ. 2022 Apr 1;12(2):e12000. doi: 10.1002/pul2.12000. eCollection 2022 Apr.

Abstract

Pulmonary hypertension (PH) is a complex disease with increasing global incidence that eventually leads to right ventricular failure and is associated with a poor prognosis. The importance of noncardiac comorbidities in disease progression and prognosis has gained increasing recognition in recent years. In the present study, we investigated a potential association between PH and cancer in an outpatient cohort in Germany. Using the IQVIA Disease Analyzer database, we identified a total of 11,109 patients with PH and a propensity score matched cohort of equal size without PH who received medical treatment between 2005 and 2019. Logistic regression models were used to evaluate the potential association between PH and cancer. Within the 10-year observation period, the incidence of cancer was significantly higher in PH patients than non-PH patients (23.2% vs. 8.5%, log-rank < 0.001). Importantly, this association was observed for both male (HR = 1.24, = 0.002) and female (HR = 1.37,  < 0.001) patients, and was most pronounced in patients >80 years (HR = 1.50,  <  0.001). In terms of a specific tumor site, we found a significant association for respiratory organ cancer (HR = 1.60,  = 0.007) and skin cancer (HR = 1.48,  < 0.001). Our study provides strong evidence that PH is associated with an increased incidence of cancer. This finding should help raise awareness of this important comorbidity and could trigger specific screening programs in patients with PH.

摘要

肺动脉高压(PH)是一种全球发病率不断上升的复杂疾病,最终会导致右心室衰竭,且预后较差。近年来,非心脏合并症在疾病进展和预后中的重要性越来越受到认可。在本研究中,我们调查了德国一个门诊队列中PH与癌症之间的潜在关联。利用IQVIA疾病分析器数据库,我们确定了总共11109例PH患者以及一个倾向评分匹配的同等规模的无PH队列,这些患者在2005年至2019年期间接受了药物治疗。使用逻辑回归模型来评估PH与癌症之间的潜在关联。在10年观察期内,PH患者的癌症发病率显著高于非PH患者(23.2%对8.5%,对数秩<0.001)。重要的是,男性(HR = 1.24, = 0.002)和女性(HR = 1.37, < 0.001)患者均观察到这种关联,并且在80岁以上患者中最为明显(HR = 1.50, < 0.001)。就特定肿瘤部位而言,我们发现呼吸器官癌症(HR = 1.60, = 0.007)和皮肤癌(HR = 1.48, < 0.001)存在显著关联。我们的研究提供了强有力的证据表明PH与癌症发病率增加有关。这一发现应有助于提高对这一重要合并症的认识,并可能引发针对PH患者的特定筛查项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e4a/9235867/46e946b0ce19/PUL2-12-e12000-g001.jpg

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