Division Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA.
Information Management Services, Inc., Rockville, Maryland, USA.
Int J Cancer. 2023 Jan 15;152(2):172-182. doi: 10.1002/ijc.34235. Epub 2022 Sep 5.
Pancreatic cancer (PC) is highly fatal, and its incidence is increasing in the United States. Population-based registry studies suggest associations between a few autoimmune conditions and PC risk, albeit based on a relatively small number of cases. We conducted a population-based, nested case-control study to examine the associations between autoimmune conditions and PC risk within the Surveillance, Epidemiology, and End Results Program (SEER)-Medicare population. Incident primary malignant PC cases (n = 80 074) were adults ≥66 years and diagnosed between 1992 and 2015. Controls (n = 320 296) were alive at the time cases were diagnosed and frequency-matched to cases (4:1 ratio) by age, sex, and year of diagnosis. We used multivariable-adjusted, unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for 45 autoimmune conditions identified from Medicare claims. Eight autoimmune conditions including ankylosing spondylitis (OR = 1.45; 95% CI: 1.14-1.84), Graves' disease (OR = 1.18; 95% CI: 1.03-1.34), localized scleroderma (OR = 1.27; 95% CI: 1.06-1.52), pernicious anemia (OR = 1.08; 95% CI: 1.02-1.14), primary sclerosing cholangitis (OR = 1.37; 95% CI: 1.18-1.59), pure red cell aplasia (OR = 1.31; 95% CI: 1.16-1.47), type 1 diabetes (OR = 1.11; 95% CI: 1.07-1.15), and ulcerative colitis (OR = 1.18; 95% CI: 1.07-1.31) were associated with increased PC risk (false discovery rate-adjusted P values <.10). In subtype analyses, these conditions were associated with pancreatic ductal adenocarcinoma, whereas only ulcerative colitis was associated with pancreatic neuroendocrine tumors. Our results support the hypothesis that autoimmune conditions may play a role in PC development.
胰腺癌（PC）的死亡率很高，其发病率在美国呈上升趋势。基于人群的登记研究表明，一些自身免疫性疾病与 PC 风险之间存在关联，尽管这些研究基于相对较少的病例。我们进行了一项基于人群的巢式病例对照研究，以检查在美国监测、流行病学和最终结果计划（SEER）-医疗保险人群中自身免疫性疾病与 PC 风险之间的关联。80074 例新确诊的原发性恶性 PC 病例（n）为年龄≥66 岁且 1992 年至 2015 年间诊断的成年人。对照组（n）为病例诊断时存活且按年龄、性别和诊断年份与病例以 4:1 的比例匹配的 320296 人。我们使用多变量调整的非条件逻辑回归计算了 8 种自身免疫性疾病（包括强直性脊柱炎[OR=1.45；95%CI：1.14-1.84]、格雷夫斯病[OR=1.18；95%CI：1.03-1.34]、局限性硬皮病[OR=1.27；95%CI：1.06-1.52]、恶性贫血[OR=1.08；95%CI：1.02-1.14]、原发性硬化性胆管炎[OR=1.37；95%CI：1.18-1.59]、纯红细胞再生障碍性贫血[OR=1.31；95%CI：1.16-1.47]、1 型糖尿病[OR=1.11；95%CI：1.07-1.15]和溃疡性结肠炎[OR=1.18；95%CI：1.07-1.31]）与 PC 风险增加相关（假发现率调整 P 值<.10）。在亚型分析中，这些疾病与胰腺导管腺癌相关，而只有溃疡性结肠炎与胰腺神经内分泌肿瘤相关。我们的结果支持自身免疫性疾病可能在 PC 发展中起作用的假说。
