Incidence of Cancer in ANCA-Associated Vasculitis: A Meta-Analysis of Observational Studies.
Incidence of Cancer in ANCA-Associated Vasculitis: A Meta-Analysis of Observational Studies.
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ANCA 相关血管炎的癌症发病率：观察性研究的荟萃分析
DOI：
10.1371/journal.pone.0126016
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Xu G
中科院分区：
文献类型：
--
作者：
Shang W;Ning Y;Xu X;Li M;Guo S;Han M;Zeng R;Ge S;Xu G
目的应用Meta分析方法研究人群队列研究中ANCA相关性脉管炎(AASV)患者的肿瘤发病率。方法检索相关电子数据库，寻找AASV患者总体恶性相关风险的研究。标准化发病率(SIRS)和95%可信区间(CI)用于评估关联强度。我们测试了发表偏倚和异质性，并对特定部位的癌症进行了分层。结果最终确定了6项研究(n=2,578)，其中6项针对总体恶性肿瘤，5项针对非黑色素瘤皮肤癌(NMSC)，4项针对白血病，5项针对膀胱癌，3项针对淋巴瘤，3项针对肝癌，4项针对肺癌，3项针对肾癌，4项针对前列腺癌，4项针对结肠癌，4项针对乳腺癌。总体而言，AASV患者的癌症合并SIR为1.74(95%CI=1.37-2.21)，这些研究之间具有中等的异质性(I2=65.8%，P=0.012)。AASV患者的SIR分别为5.18(95%CI=3.47~7.73)、4.89(95%CI=2.93~8.16)和3.84(95%CI=2.72~5.42)。患肾癌(SIR=2.12，95%CI=0.66~6.85)、前列腺癌(SIR=1.45，95%CI=0.87~2.42)、结肠癌(SIR=1.26，95%CI=0.70~2.27)和乳腺癌(SIR=0.95，95%CI=0.50~1.79)的风险无显著增加。在这些特定部位的癌中，只有NMSC表现出中等异质性(I2=55.8%，P=0.06)。采用Begg‘s检验和Egger’s检验，未发现发表偏倚。结论这一荟萃分析显示，环磷酰胺(CyC)治疗的AASV患者发生晚期恶性肿瘤的风险增加，特别是NMSC、白血病和膀胱癌。然而，AASV与肾癌、前列腺癌、结肠癌和乳腺癌没有明显的相关性。这些发现强调了AASV患者在停止环磷酰胺治疗后的监测和预防性管理是重要的。
Objective The purpose of this paper is to examine cancer incidence in patients with ANCA-associated vasculitis (AASV) derived from population-based cohort studies by means of meta-analysis. Methods Relevant electronic databases were searched for studies characterizing the associated risk of overall malignancy in patients with AASV. Standardized incidence rates (SIRs) with 95% confidence intervals (CIs) were used to evaluate the strength of association. We tested for publication bias and heterogeneity and stratified for site-specific cancers. Results Six studies (n = 2,578) were eventually identified, of which six provided the SIR for overall malignancy, five reported the SIR for non-melanoma skin cancer (NMSC), four for leukemia, five for bladder cancer, three for lymphoma, three for liver cancer, four for lung cancer, three for kidney cancer, four for prostate cancer, four for colon cancer and four for breast cancer. Overall, the pooled SIR of cancer in AASV patients was 1.74 (95%CI = 1.37–2.21), with moderate heterogeneity among these studies (I2 = 65.8%, P = 0.012). In sub-analyses for site-specific cancers, NMSC, leukemia and bladder cancer were more frequently observed in patients with AASV with SIR of 5.18 (95%CI = 3.47–7.73), 4.89 (95%CI = 2.93–8.16) and 3.84 (95%CI = 2.72–5.42) respectively. There was no significant increase in the risk of kidney cancer (SIR = 2.12, 95%CI = 0.66–6.85), prostate cancer (SIR = 1.45, 95%CI = 0.87–2.42), colon cancer (SIR = 1.26, 95%CI = 0.70–2.27), and breast cancer (SIR = 0.95, 95%CI = 0.50–1.79). Among these site-specific cancers, only NMSC showed moderate heterogeneity (I2 = 55.8%, P = 0.06). No publication bias was found by using the Begg’s test and Egger's test. Conclusions This meta-analysis shows that AASV patients treatment with cyclophosphamide (CYC) are at increased risk of late-occurring malignancies, particularly of the NMSC, leukemia and bladder cancer. However, there is no significant association between AASV and kidney cancer, prostate cancer, colon cancer and breast cancer. These findings emphasize monitoring and preventative management in AASV patients after cessation of CYC therapy is momentous.
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硫唑嘌呤和UVA光产生诱变的氧化DNA损伤。
DOI：
10.1126/science.1114233
发表时间：
2005-09-16
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
O'Donovan P;Perrett CM;Zhang X;Montaner B;Xu YZ;Harwood CA;McGregor JM;Walker SL;Hanaoka F;Karran P
通讯作者：
Karran P
影响因子：
--
作者：
Silva, Francisco;Seo, Philip;Schroeder, Darrell R.;Stone, John H.;Merkel, Peter A.;Hoffman, Gary S.;Spiera, Robert;Sebastian, Jodi K.;Davis, John C., Jr.;St Clair, E. William;Allen, Nancy B.;McCune, W. Joseph;Ytterberg, Steven R.;Specks, Ulrich
通讯作者：
Specks, Ulrich
影响因子：
27.4
作者：
Flossmann, Oliver;Berden, Annelies;Westman, Kerstin
通讯作者：
Westman, Kerstin
影响因子：
27.4
作者：
Heijl, C.;Harper, L.;Mahr, A.
通讯作者：
Mahr, A.
影响因子：
--
作者：
Holle, Julia U.;Gross, Wolfgang L.;Reinhold-Keller, Eva
通讯作者：
Reinhold-Keller, Eva