Cancer in patients with ulcerative colitis, Crohn's disease and coeliac disease: record linkage study
Cancer in patients with ulcerative colitis, Crohn's disease and coeliac disease: record linkage study
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DOI：
10.1097/meg.0b013e3282f2a5e2
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发表时间：
2008-04-01
影响因子：
2.1
通讯作者：
Jewell, Derek
中科院分区：
文献类型：
--
作者：
Goldacre, Michael J.;Wotton, Clare J.;Jewell, Derek
目的本研究的目的是确定溃疡性结肠炎、克罗恩病或乳糜泻患者队列与对照队列的癌症风险。方法使用的方法是分析英格兰南部一个地区医院和死亡率数据的关联统计数据库。结果溃疡性结肠炎、克罗恩病或乳糜泻患者队列的癌症风险比（不包括随访第一年内发生的病例），与对照队列中的值1相比，（95%置信区间（CI），1.13-1.39），克罗恩病为1.27（95% CI，1.11-1.45），乳糜泻为1.16（95% CI，0.94-1.43）。在溃疡性结肠炎或克罗恩病患者中，结肠癌的风险显著较高[分别为2.22（95% CI，1.71-2.83）和1.64（95% CI，1.09-2.39）]。溃疡性结肠炎患者发生直肠癌的风险显著较高[1.84（95% CI，1.27-2.58）]。在溃疡性结肠炎或克罗恩病患者中，未接受部分或全结肠切除术，结肠癌的比率分别为5.52（95%CI，4.39-6.71）和4.81（95%CI，3.52-6.47）。在溃疡性结肠炎中，直肠癌、肝癌和卵巢癌的风险增加。肺癌的比率较低，但具有临界显著性[0.72（95% CI，0.50-0.98）]。在克罗恩病中，宫颈癌的发生率比值较高[2.63（95% CI，1.12-5.29）]。在腹腔疾病患者中，非霍奇金淋巴瘤是高危癌症[率比3.28（95%CI，1.49-6.28）]。结论所有三种疾病在纳入第一年病例时总体上都有癌症风险增加，尽管规模相当适度，但在排除第一年病例后，腹腔疾病的风险增加减少。每种癌症都有其独特的高危癌症模式。
Objective The objective of this study was to determine the risk of cancers in cohorts of patients with ulcerative colitis, Crohn's disease, or coeliac disease, compared with the risk in a control cohort.Method The method used was the analysis of a linked statistical database of hospital and mortality data in an area in southern England.Results Rate ratios for cancer (excluding cases occurring within the first year of follow-up), compared with the value of 1 in the control cohort, were 1.25 (95% confidence interval (Cl), 1.13-1.39] in patients with ulcerative colitis, 1.27 (95% Cl, 1.11-1.45) with Crohn's disease, and 1.16 (95% Cl, 0.94-1.43) with coeliac disease. In patients with ulcerative colitis or Crohn's disease, there was a significantly high risk of cancer of the colon [2.22 (95% Cl, 1.71-2.83) and 1.64 (95% Cl, 1.09-2.39), respectively]. In patients with ulcerative colitis there was a significantly high risk of cancer of the rectum [1.84 (95% Cl, 1.27-2.58)]. In patients with ulcerative colitis or Crohn's disease, who did not undergo partial or total colectomy for it, the rate ratios for colon cancer were, respectively, 5.52 (95% Cl, 4.39-6.71) and 4.81 (95% Cl, 3.52-6.47). In ulcerative colitis, there was an elevated risk of cancer of the rectum, liver and ovary. The rate ratio for lung cancer was low, but of borderline significance [0.72 (95% Cl, 0.50-0.98)]. In Crohn's disease, the rate ratio was high for cancer of the cervix [2.63 (95% Cl, 1.12-5.29)]. In patients with coeliac disease, the high-risk cancer was non-Hodgkin's lymphoma [rate ratio 3.28 (95% Cl, 1.49-6.28)].Conclusion All three diseases carry an increased risk of cancer overall when the first year cases are included, though fairly modest in scale, and the increased risk seen in coeliac disease reduces when first year cases are excluded. Each has a distinctive pattern of individual high-risk cancers.