PDF(Pubmed)
Abstract：
UNASSIGNED: It is unclear whether Guillain-Barré syndrome (GBS) can be a marker of a paraneoplastic syndrome. We examined whether GBS is associated with cancer and whether the prognosis of GBS patients with cancer differs from that of other cancer patients.
UNASSIGNED: We conducted a population-based cohort study of patients diagnosed with GBS between 1978 and 2017 using Danish registry-data. Main outcome measures were cancer incidence and mortality after cancer diagnosis. We calculated absolute risks of a cancer diagnosis, treating death as competing risk, and standardized incidence ratios (SIRs) as measures of relative risk. We matched each GBS cancer patient with up to 10 cancer patients without a GBS diagnosis and examined the six-month survival after cancer diagnosis using Cox regression analysis.
UNASSIGNED: We identified 7897 patients (58% male, median age 57 years) with GBS. During a median follow-up of 9.5 years, the one-year risk of cancer was 2.7% (95% confidence interval (CI), 2.4-3.1). The SIR was increased throughout follow-up, but most noticeably during the first year after diagnosis (SIR: 3.35, 2.92-3.83). SIRs were particularly elevated for hematologic cancers (SIR: 8.67, 6.49-11.34), smoking-related cancers (SIR: 3.57, 2.81-4.47), and cancers of neurological origin (SIR: 8.60, 5.01-13.77). Lung cancer was the main contributor to the overall excess risk, which persisted after 36 months of follow-up (SIR: 1.17, 1.09-1.25). The mortality rate ratio comparing patients diagnosed with any cancer within one year of their GBS diagnosis and matched GBS-free cancer cohort members was 1.56 (95% CI, 1.27-1.90).
UNASSIGNED: GBS patients had a three-fold increased risk of cancer diagnosis in the first year of follow-up. The absolute cancer risk was almost 3.0%. A GBS diagnosis was an adverse prognostic marker for survival following cancer diagnosis. Clinicians should consider occult cancer in patients hospitalized with GBS.
UNASSIGNED: We conducted a population-based cohort study of patients diagnosed with GBS between 1978 and 2017 using Danish registry-data. Main outcome measures were cancer incidence and mortality after cancer diagnosis. We calculated absolute risks of a cancer diagnosis, treating death as competing risk, and standardized incidence ratios (SIRs) as measures of relative risk. We matched each GBS cancer patient with up to 10 cancer patients without a GBS diagnosis and examined the six-month survival after cancer diagnosis using Cox regression analysis.
UNASSIGNED: We identified 7897 patients (58% male, median age 57 years) with GBS. During a median follow-up of 9.5 years, the one-year risk of cancer was 2.7% (95% confidence interval (CI), 2.4-3.1). The SIR was increased throughout follow-up, but most noticeably during the first year after diagnosis (SIR: 3.35, 2.92-3.83). SIRs were particularly elevated for hematologic cancers (SIR: 8.67, 6.49-11.34), smoking-related cancers (SIR: 3.57, 2.81-4.47), and cancers of neurological origin (SIR: 8.60, 5.01-13.77). Lung cancer was the main contributor to the overall excess risk, which persisted after 36 months of follow-up (SIR: 1.17, 1.09-1.25). The mortality rate ratio comparing patients diagnosed with any cancer within one year of their GBS diagnosis and matched GBS-free cancer cohort members was 1.56 (95% CI, 1.27-1.90).
UNASSIGNED: GBS patients had a three-fold increased risk of cancer diagnosis in the first year of follow-up. The absolute cancer risk was almost 3.0%. A GBS diagnosis was an adverse prognostic marker for survival following cancer diagnosis. Clinicians should consider occult cancer in patients hospitalized with GBS.
摘要：
■目前尚不清楚格林-巴利综合征（GBS）是否可以作为副肿瘤综合征的标志。我们检查了GBS是否与癌症相关，以及GBS癌症患者的预后是否与其他癌症患者的预后不同。
■我们使用丹麦注册数据对1978年至2017年间诊断为GBS的患者进行了一项基于人群的队列研究。主要结局指标为癌症诊断后的癌症发病率和死亡率。我们计算了癌症诊断的绝对风险，将死亡视为竞争风险，和标准化发生率(SIR)作为相对风险的衡量标准。我们将每位GBS癌症患者与多达10位没有GBS诊断的癌症患者进行匹配，并使用Cox回归分析检查了癌症诊断后的六个月生存率。
■我们确定了7897名患者（58％为男性，中位年龄57岁）与GBS。在9.5年的中位随访期间，一年的癌症风险为2.7%(95%置信区间(CI)，2.4-3.1)。在整个随访期间，SIR增加，但最明显的是在诊断后的第一年（SIR：3.35，2.92-3.83）。SIR在血液系统癌症中尤其升高（SIR：8.67，6.49-11.34），与吸烟有关的癌症（SIR：3.57，2.81-4.47），和神经起源的癌症(SIR:8.60,5.01-13.77)。肺癌是总体超额风险的主要原因，随访36个月后持续存在（SIR：1.17，1.09-1.25）。在GBS诊断后一年内被诊断为任何癌症的患者和匹配的无GBS癌症队列成员的死亡率比率为1.56(95%CI,1.27-1.90)。
■GBS患者在随访的第一年中被诊断为癌症的风险增加了3倍。癌症的绝对风险几乎是3.0%。GBS诊断是癌症诊断后生存的不良预后标志物。临床医生应考虑GBS住院患者的隐匿性癌症。
■我们使用丹麦注册数据对1978年至2017年间诊断为GBS的患者进行了一项基于人群的队列研究。主要结局指标为癌症诊断后的癌症发病率和死亡率。我们计算了癌症诊断的绝对风险，将死亡视为竞争风险，和标准化发生率(SIR)作为相对风险的衡量标准。我们将每位GBS癌症患者与多达10位没有GBS诊断的癌症患者进行匹配，并使用Cox回归分析检查了癌症诊断后的六个月生存率。
■我们确定了7897名患者（58％为男性，中位年龄57岁）与GBS。在9.5年的中位随访期间，一年的癌症风险为2.7%(95%置信区间(CI)，2.4-3.1)。在整个随访期间，SIR增加，但最明显的是在诊断后的第一年（SIR：3.35，2.92-3.83）。SIR在血液系统癌症中尤其升高（SIR：8.67，6.49-11.34），与吸烟有关的癌症（SIR：3.57，2.81-4.47），和神经起源的癌症(SIR:8.60,5.01-13.77)。肺癌是总体超额风险的主要原因，随访36个月后持续存在（SIR：1.17，1.09-1.25）。在GBS诊断后一年内被诊断为任何癌症的患者和匹配的无GBS癌症队列成员的死亡率比率为1.56(95%CI,1.27-1.90)。
■GBS患者在随访的第一年中被诊断为癌症的风险增加了3倍。癌症的绝对风险几乎是3.0%。GBS诊断是癌症诊断后生存的不良预后标志物。临床医生应考虑GBS住院患者的隐匿性癌症。
