胆汁酸腹泻患者罹患癌症的风险:一项丹麦全国性匹配队列研究

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Nynne Nyboe Andersen, Signe Wildt, Aske Thorn Iversen, Gry Poulsen, Tine Jess, Lars Kristian Munck, Christian Borup
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A competing risk model estimated cumulative incidence functions and cause-specific HRs. Results We identified 2260 patients with bile acid diarrhoea with a mean follow-up of 5.5 years (SD 4.2). The overall cancer risk was increased by an HR of 1.32 (95% CI 1.12 to 1.54). The risk of site-specific cancer was increased in 3 of 10 cancer groups: haematological, HR 2.41 (1.36 to 4.02); skin, HR 1.33 (1.01 to 1.71); and male genital cancers, HR 1.85 (1.11 to 2.92). No increased risk of colorectal cancer was detected in patients with bile acid diarrhoea, HR 0.73 (0.34 to 1.63). Conclusions Bile acid diarrhoea was associated with an increased overall risk of cancer, especially haematological cancers, but the risk of colorectal cancer was not increased. The lack of a diagnostic code for bile acid diarrhoea and potential residual confounding are limitations, and the findings should be replicated in other cohorts. 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引用次数: 0

摘要

目标 胆汁酸性腹泻是慢性腹泻的常见病因。从理论上讲,粪便中潜在致癌胆汁酸含量的增加可能会增加罹患结直肠癌的风险,但其长期病程尚不清楚。我们的目的是调查胆汁酸腹泻的总体癌症风险和特定部位癌症风险。设计 从 2003 年到 2020 年,我们通过丹麦全国范围内的登记册确定了胆汁酸腹泻的成年患者,他们接受了金标准 75 硒牛磺胆酸诊断程序,并在 6 个月内接受了螯合剂处方。将胆汁酸腹泻病例的总体癌症风险和特定部位癌症风险与性别、年龄和合并症调整后的匹配对照组进行了比较。竞争风险模型估算了累积发病率函数和病因特异性 HR。结果 我们确定了 2260 名胆汁酸腹泻患者,平均随访时间为 5.5 年(SD 4.2)。总体癌症风险增加的HR为1.32(95% CI为1.12至1.54)。在 10 个癌症组别中,有 3 个组别发生特定部位癌症的风险增加:血液癌症,HR 值为 2.41(1.36 至 4.02);皮肤癌,HR 值为 1.33(1.01 至 1.71);男性生殖器癌症,HR 值为 1.85(1.11 至 2.92)。未发现胆汁酸腹泻患者罹患结直肠癌的风险增加,HR 为 0.73(0.34 至 1.63)。结论 胆汁酸腹泻与癌症(尤其是血液癌症)总风险的增加有关,但结肠直肠癌的风险并没有增加。缺乏胆汁酸腹泻的诊断代码和潜在的残余混杂因素是研究的局限性,研究结果应在其他队列中重复。与该研究相关的所有数据均包含在文章中或作为补充信息上传。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of cancer in patients with bile acid diarrhoea: a Danish nationwide matched cohort study
Objective Bile acid diarrhoea is a common cause of chronic diarrhoea. Increased levels of potentially carcinogenic bile acids in faeces, theoretically, may increase the risk of colorectal cancer in particular, but the long-term disease course is unknown. We aimed to investigate the overall and site-specific cancer risk in bile acid diarrhoea. Design Adult patients with bile acid diarrhoea were identified using nationwide Danish registries from 2003 to 2020 by a diagnostic gold-standard 75-selenium tauroselcholic acid procedure followed within 6 months by sequestrant prescription. The risk of overall and site-specific cancers in cases with bile acid diarrhoea was compared with sex, age and comorbidity-adjusted matched controls. A competing risk model estimated cumulative incidence functions and cause-specific HRs. Results We identified 2260 patients with bile acid diarrhoea with a mean follow-up of 5.5 years (SD 4.2). The overall cancer risk was increased by an HR of 1.32 (95% CI 1.12 to 1.54). The risk of site-specific cancer was increased in 3 of 10 cancer groups: haematological, HR 2.41 (1.36 to 4.02); skin, HR 1.33 (1.01 to 1.71); and male genital cancers, HR 1.85 (1.11 to 2.92). No increased risk of colorectal cancer was detected in patients with bile acid diarrhoea, HR 0.73 (0.34 to 1.63). Conclusions Bile acid diarrhoea was associated with an increased overall risk of cancer, especially haematological cancers, but the risk of colorectal cancer was not increased. The lack of a diagnostic code for bile acid diarrhoea and potential residual confounding are limitations, and the findings should be replicated in other cohorts. All data relevant to the study are included in the article or uploaded as supplemental information.
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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