Mohammed Alzahra A, Lengyel Anna S, Meznerics Fanni A, Szondy István, Walter Anna, Nagy Benedek, Csábi Zsófia, Bánvölgyi András, Kiss Norbert, Hegyi Péter, Kurgyis Zsuzsanna, Kemény Lajos V
Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, 1085, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, 1085, Hungary.
Dermatol Ther (Heidelb). 2025 Aug 18. doi: 10.1007/s13555-025-01520-0.
Vitiligo, a chronic depigmenting disorder affecting 1-2% of the global population, is caused by immune-mediated melanocyte destruction. While its pathogenesis is multifactorial, the relationship between vitiligo and malignancy risk remains controversial. Some studies suggest an increased cancer risk, while others propose a potential protective effect, particularly against skin cancers. This study provides a comprehensive evaluation of malignancy risks in patients with vitiligo.
This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered with PROSPERO (CRD42023483130). A comprehensive search was conducted across Medline, EMBASE, and Cochrane databases. Studies reporting hazard ratios for malignancy incidence in patients with vitiligo were included. Data extraction and risk of bias assessment were performed using the Cochrane ROBINS-E tool.
Of 7753 records identified, 6378 remained after duplicates were removed, and 12 studies were included in the final review. Quantitative analysis was performed on six studies. The combined sample comprised 3,267,951 participants, including 289,322 patients with vitiligo. Three meta-analyses were conducted for melanoma, non-melanoma skin cancer, and lymphoma. The pooled hazard ratio (HR) for lymphoma was 1.00 (95% CI 0.40-2.53), for melanoma 0.80 (95% CI 0.27-2.34), and for non-melanoma skin cancer 0.38 (95% CI 0.00-732.76), suggesting no consistent associations.
This meta-analysis did not identify significant differences in cancer risk across the examined subgroups. While a protective effect of vitiligo against some malignancies cannot be excluded, substantial heterogeneity among studies warrants cautious interpretation. Further high-quality research is needed to clarify these associations.
白癜风是一种慢性色素脱失性疾病，影响全球1%-2%的人口，由免疫介导的黑素细胞破坏引起。虽然其发病机制是多因素的，但白癜风与恶性肿瘤风险之间的关系仍存在争议。一些研究表明癌症风险增加，而另一些研究则提出潜在的保护作用，特别是对皮肤癌。本研究对白癜风患者的恶性肿瘤风险进行了全面评估。
本系统评价和荟萃分析遵循PRISMA 2020指南，并在PROSPERO（CRD42023483130）注册。对Medline、EMBASE和Cochrane数据库进行了全面检索。纳入报告白癜风患者恶性肿瘤发病率风险比的研究。使用Cochrane ROBINS-E工具进行数据提取和偏倚风险评估。
在识别出的7753条记录中，去除重复记录后剩余6378条，最终纳入12项研究进行综述。对6项研究进行了定量分析。合并样本包括3267951名参与者，其中白癜风患者289322例。对黑色素瘤、非黑色素瘤皮肤癌和淋巴瘤进行了三项荟萃分析。淋巴瘤的合并风险比（HR）为1.00（95%CI 0.40-2.53），黑色素瘤为0.80（95%CI 0.27-2.34），非黑色素瘤皮肤癌为0.38（95%CI 0.00-732.76），表明无一致关联。
本荟萃分析未发现所检查亚组之间癌症风险存在显著差异。虽然不能排除白癜风对某些恶性肿瘤的保护作用，但研究之间存在大量异质性，需要谨慎解读。需要进一步的高质量研究来阐明这些关联。
