Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis.
Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis.
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DOI：
10.1371/journal.pone.0243150
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Davis MF
中科院分区：
文献类型：
--
作者：
Johnson DK;Reynolds KM;Poole BD;Montierth MD;Todd VM;Barnado A;Davis MF
与一般人群相比，自身免疫性疾病（AD）患者的癌症风险发生了变化。系统性红斑狼疮和多发性硬化导致血液系统恶性肿瘤的风险增加，乳腺癌、卵巢癌和前列腺恶性肿瘤的风险降低。自身免疫性疾病患者通常具有失调的抗病毒免疫应答，包括针对致癌病毒的应答。为了揭示自身免疫性疾病背景下病毒发病率和癌症风险之间的关系，我们提取了范德比尔特大学的电子健康记录（EHR）。收集血液、肺、肛门-阴道、甲状腺、肝胆、膀胱、前列腺和乳腺癌的ICD-9/10代码和实验室检查值;以及病毒，包括爱泼斯坦巴尔病毒（EBV）、人乳头瘤病毒（HPV）和甲型/B/丙型肝炎（Hep）。仅将导致医生访视或实验室检查的病毒感染输入EMR;因此，在本研究中仅观察到临床相关病例并视为阳性。通过多线性logistic回归分析SLE队列（SLE病例n = 2，313，SLE对照n = 5，702）和MS队列（MS病例n = 7，277，MS对照n = 7，277）中病毒感染与癌症之间的关系。病毒感染与总体癌症风险增加密切相关。SLE和MS患者更容易感染所有病毒。MS患者总体上倾向于癌症风险增加，而SLE患者中基于乳腺癌的癌症风险降低并不显著降低其总体癌症风险。SLE和MS患者的临床相关EBV感染增加，这与血液系统癌症的风险有关。通过接种疫苗预防病毒感染可能特别有助于控制SLE和MS患者的癌症风险。
Patients with autoimmune disorders (AD) have altered cancer risks compared to the general population. Systemic lupus erythematosus and multiple sclerosis lead to a heightened risk for hematological malignancies and decreased risk for breast, ovarian, and prostate malignancies. Often patients with autoimmune disease have dysregulated antiviral immune responses, including against oncogenic viruses. To uncover the relationship between viral incidence and cancer risk in the context of autoimmune disease, we extracted electronic health records (EHR) from Vanderbilt University. ICD-9/10 codes and laboratory values were collected for hematological, lung, anal-vaginal, thyroid, hepatobiliary, bladder, prostate, and breast cancers; and viruses including Epstein Barr virus (EBV), Human papilloma virus (HPV), and Hepatitis A/B/C (Hep). Only viral infections that led to a physician visit or laboratory test were entered into the EMR; therefore, only clinically relevant cases were noted and considered positive in this study. The relationship between virus infection and cancer in an SLE cohort (SLE-cases n = 2,313, and SLE-controls n = 5,702) and an MS cohort (MS-case n = 7,277, MS-control n = 7,277) was examined by multilinear logistic regression. Viral infection was strongly associated with increased risk for cancer overall. SLE and MS patients were more susceptible to all viral infections. MS patients trended toward increased risk for cancers overall, while decreased risk for hormone-based cancers in SLE patients non-significantly reduced their risk for overall cancer. Both SLE and MS patients had increased clinically relevant EBV infection, which was associated with risk for hematological cancers. Preventing viral infections by vaccination may be especially helpful in controlling risk for cancer in SLE and MS patients.
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DOI：
10.1136/amiajnl-2013-001999
发表时间：
2013-12
期刊：
Journal of the American Medical Informatics Association : JAMIA
影响因子：
--
作者：
Davis MF;Sriram S;Bush WS;Denny JC;Haines JL
通讯作者：
Haines JL
影响因子：
--
作者：
AbuShakra, M;Gladman, DD;Urowitz, MB
通讯作者：
Urowitz, MB
影响因子：
11.2
作者：
Hauser, Stephen L.;Chan, Jonah R.;Oksenberg, Jorge R.
通讯作者：
Oksenberg, Jorge R.
影响因子：
5.1
作者：
James JA;Robertson JM
通讯作者：
Robertson JM
DOI：
10.1016/j.berh.2017.09.013
发表时间：
2017-06
期刊：
Best practice & research. Clinical rheumatology
影响因子：
--
作者：
Choi MY;Flood K;Bernatsky S;Ramsey-Goldman R;Clarke AE
通讯作者：
Clarke AE