背景:乳糜泻(CeD)是一种由遗传易感个体对谷蛋白的免疫反应引发的自身免疫性疾病。最近的研究揭示了发生特定恶性肿瘤(MN)和各种恶性肿瘤的风险增加,包括胃肠,淋巴瘤,皮肤,和其他人,在与CeD的个人。
目的:调查美国住院CeD患者中MN的患病率。
方法:使用来自全国住院患者样本的数据,从2000年1月到2019年12月,我们确定了529842例CeD患者,其中78128人(14.75%)患有MN。倾向得分匹配,根据年龄,性别,种族,和日历年,以1:1的比例比较CeD患者和一般非CeD人群。
结果:观察到一些恶性肿瘤呈正相关,包括小肠,淋巴瘤非黑色素瘤皮肤,肝脏,黑色素瘤皮肤,胰腺骨髓增生异常综合征,胆道,胃,和其他神经内分泌肿瘤(不包括小肠和大肠恶性类癌),白血病,子宫,和睾丸。相反,CeD患者出现呼吸道和继发性恶性肿瘤的风险降低。此外,某些恶性肿瘤与CeD无关联,包括头部和颈部,神经系统,食道,结直肠,肛门,乳房,恶性类癌,骨骼和结缔组织,骨髓瘤,子宫颈,和卵巢癌。
结论:我们的研究是独一无二的,负,不同血液学和实体恶性肿瘤与CeD之间的关联或无效。此外,它提供了对CeD医院结果演变趋势的见解,揭示了过去二十年来其管理方面的进步。这些发现有助于理解CeD对健康和医疗保健利用的影响。
BACKGROUND: Celiac disease (CeD) is an autoimmune disorder triggered by the immune response to gluten in genetically predisposed individuals. Recent research has unveiled a heightened risk of developing specific malignant neoplasms (MN) and various malignancies, including gastrointestinal, lymphomas, skin, and others, in individuals with CeD.
OBJECTIVE: To investigate the prevalence of MN in hospitalized CeD patients in the United States.
METHODS: Using data from the National Inpatient Sample spanning two decades, from January 2000 to December 2019, we identified 529842 CeD patients, of which 78128 (14.75%) had MN. Propensity score matching, based on age, sex, race, and calendar year, was employed to compare CeD patients with the general non-CeD population at a 1:1 ratio.
RESULTS: Positive associations were observed for several malignancies, including small intestine, lymphoma, nonmelanoma skin, liver, melanoma skin, pancreas myelodysplastic syndrome, biliary, stomach, and other neuroendocrine tumors (excluding small and large intestine malignant carcinoid), leukemia, uterus, and testis. Conversely, CeD patients exhibited a reduced risk of respiratory and secondary malignancies. Moreover, certain malignancies showed null associations with CeD, including head and neck, nervous system, esophagus, colorectal, anus, breast, malignant carcinoids, bone and connective tissues, myeloma, cervix, and ovary cancers.
CONCLUSIONS: Our
study is unique in highlighting the detailed results of positive, negative, or null associations between different hematologic and solid malignancies and CeD. Furthermore, it offers insights into evolving trends in CeD hospital outcomes, shedding light on advancements in its management over the past two decades. These findings contribute valuable information to the understanding of CeD\'s impact on health and healthcare utilization.