Clin Gastroenterol H:乳糜泻患者患癌风险分析

2021-05-23 MedSci原创 MedSci原创

即使在最近几年,CD患者发生癌症的风险也会增加,但是这种风险的增加仅限于60岁以后被诊断为CD的人群,并且主要发生于CD诊断后的第一年内。

乳糜泻(CD)与死亡率增加相关,部分原因是由于癌症。

近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员进行了基于人群的研究以探究CD患者的癌症风险。

研究人员使用ESPRESSO队列确定了瑞典所有CD患者,其定义为十二指肠绒毛萎缩。每名患者按年龄、性别和所在县市均匹配5以内的对照者。研究人员从患者CD诊断到首次癌症或直到2016年12月31日进行随访,并使用分层Cox比例风险模型进行分析。

癌症发生率

自2000年以来,在47241名CD患者中,有30080名(64%)被明确诊断CD。中位随访11.5年后,CD患者和对照组的癌症发生率分别为6.5人和5.7人每1000人每年。癌症的总体风险有所增加(风险比[HR]为1.11;95%CI为1.07-1.15),但仅在CD诊断后的第一年才显著升高(HR为2.47;95%CI为2.22-2.74),随后则没有明显升高(HR为1.01;95%CI为0.97-1.05),尽管血液系统肿瘤、淋巴增生、肝胆和胰腺癌的风险仍然存在。在60岁以后被诊断为CD的患者中,癌症的总体风险最高(HR为1.22;95%CI为1.16-1.29),而在40岁之前被诊断为CD患者癌症的总体风险并未增加。在2000年之前或之后,被诊断为CD患者的癌症风险相似。

由此可见,即使在最近几年,CD患者发生癌症的风险也会增加,但是这种风险的增加仅限于60岁以后被诊断为CD的人群,并且主要发生于CD诊断后的第一年内。

原始出处:

Benjamin Lebwohl.et al.Cancer Risk in 47,241 Individuals with Celiac Disease – A Nationwide Cohort Study.Clinical gastroenterology and hepatology.2021.https://doi.org/10.1016/j.cgh.2021.05.034

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    2021-06-09 仁心济世
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    2021-07-28 许安
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    2021-07-30 小小医者
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    2021-09-04 sjq027
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    2021-05-25 lq0307

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