Clin Gastroenterol H:硫嘌呤治疗的炎症性肠病患者发生鳞状细胞癌的死亡率分析

2019-03-11 xing.T 网络

由此可见,尽管原因特异性死亡率相对较低,但暴露于硫嘌呤的IBD患者发生SCC后与仅暴露于5-ASA的患者相比,SCC相关死亡的风险增加。

硫嘌呤治疗与炎症性肠病(IBD)患者皮肤鳞状细胞癌(SCC)的风险增加有关。近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员分析了在接受硫嘌呤治疗的同时发生SCC的IBD患者的结据。

研究人员对2000年1月1日至2018年5月23日期间在全国范围内的退伍军人事务医疗保健系统中进行了一项回顾性队列研究,对全国范围内的549名IBD患者进行了回顾性研究。从该队列中,研究人员创建了SCC确诊的患者亚组,通过审查患者的医疗记录进行确认;研究人员确定了接受过硫嘌呤治疗的患者(暴露组)与接受5-ASA治疗的患者以及之前未接触过硫嘌呤或肿瘤坏死因子拮抗剂(未暴露组)的患者。该研究的主要结据是与SCC相关的死亡(SCC死亡率)。研究人员收集了有关基线人口统计特征指标、紫外线照射、Charlson合并症指数、吸烟状况和环境暴露的数据。随访从SCC诊断时开始,并在卫生系统中死亡或最后记录日期结束。使用特定原因的危险模型来估计SCC死亡率的调整和未调整风险比(HRs)以及95%CI。

研究人员在最终分析中确定了467次SCC事件,其中包括449名患者(161名暴露患者和288名未暴露患者)。11例具有SCC并发症患者(暴露组8例,未暴露组3例)。估计的5年和10年累积死亡率暴露组分别为2.9%和2.9%,未暴露组分别为0.4%和0.9%。与暴露相关的未调整和调整后的SCC死亡率原因特异性HR分别为7.0(95%CI为1.8-28.0; P=0.006)和8.0(95%CI为2.0-32.8; P=0.004)。

由此可见,尽管原因特异性死亡率相对较低,但暴露于硫嘌呤的IBD患者发生SCC后与仅暴露于5-ASA的患者相比,SCC相关死亡的风险增加。 


相关资源:Charlson合并症指数(aCCI)

原始出处:

Nabeel Khan,et al.Mortality Associated With Development of Squamous Cell Cancer in Patients With Inflammatory Bowel Disease Receiving Treatment With Thiopurines.Clinical gastroenterology and hepatology.2019.https://www.cghjournal.org/article/S1542-3565(19)30254-X/fulltext

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    2019-05-28 许安
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