Cho Hyung-Jin, Yoo Ju-Hwan, Kim Mi-Hyeong, Ko Kyung-Jai, Jun Kang-Woong, Han Kyung-do, Hwang Jeong-Kye
Division of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, Korea.
J Vasc Surg. 2023 Jan;77(1):80-88.e2. doi: 10.1016/j.jvs.2022.03.896. Epub 2022 Jul 15.
The cause of death for patients with an abdominal aortic aneurysm (AAA) can be related to the AAA itself. However, cancer-related mortality could also be a contributing factor. In the present study, we examined the hypothesis that an association exists between AAAs and certain cancers.
Information from 2009 to 2015 was extracted from the Korean National Health Insurance Service database. We included 14,920 participants with a new diagnosis of an AAA. Propensity score matching by age and sex with disease-free patients was used to select the control group of 44,760 participants. The primary end point of the present study was a new diagnosis of various cancers.
The hazard ratio (HR) for cancer incidence was higher in the AAA group than in the control group for hepatoma, pancreatic cancer, and lung cancer (HR, 1.376, 1.429, and 1.394, respectively). In the case of leukemia, the HR for cancer occurrence was not significantly higher in the AAA group than in the control group. However, when stratified by surgery, the HR was significantly higher for the surgical group (HR, 3.355), especially for endovascular aneurysm repair (HR, 3.864).
We found that AAAs are associated with an increased risk of cancer, in particular, hepatoma, pancreatic cancer, and lung cancer, even after adjusting for several comorbidities. Thus, continued follow-up is necessary for patients with an AAA to permit the early detection of the signs and symptoms of cancer.
腹主动脉瘤（AAA）患者的死因可能与AAA本身有关。然而，癌症相关死亡率也可能是一个促成因素。在本研究中，我们检验了AAA与某些癌症之间存在关联的假设。
从韩国国民健康保险服务数据库中提取2009年至2015年的信息。我们纳入了14920名新诊断为AAA的参与者。通过年龄和性别与无病患者进行倾向得分匹配，以选择44760名参与者作为对照组。本研究的主要终点是各种癌症的新诊断。
AAA组肝癌、胰腺癌和肺癌的癌症发病率风险比（HR）高于对照组（分别为HR 1.376、1.429和1.394）。对于白血病，AAA组癌症发生的HR并不显著高于对照组。然而，按手术分层时，手术组的HR显著更高（HR 3.355），尤其是血管内动脉瘤修复组（HR 3.864）。
我们发现，即使在调整了几种合并症后，AAA仍与癌症风险增加相关，尤其是肝癌、胰腺癌和肺癌。因此，对AAA患者进行持续随访对于早期发现癌症的体征和症状是必要的。
