背景:关于硬化性苔藓(LS)的发病率和合并症的数据,基于经过验证的全国人口登记册,仍然稀缺。目的:探讨瑞典LS合并症的发生率和相关性,强调其与恶性肿瘤和自身免疫性疾病的潜在联系。方法:从2001年1月1日至2021年1月1日,使用国家患者登记册进行了一项基于人群的回顾性开放队列研究,以确定所有诊断为LS(ICD-10代码L90.0)的个体。该研究包括154,424名LS患者和一个由463,273人组成的性别和年龄相匹配的对照组,以评估各种癌症和癌前疾病的发生率和优势比。结果:瑞典的LS发病率为每年每10万人80.9,女性发病率(114.4)高于男性(47.2)。LS患者外阴癌的比值比增加(OR=8.3;95%CI=7.5-9.0),阴茎癌(OR=8.9;95%CI=7.3-11.0),前列腺癌(OR=1.2;95%CI=1.1-1.2),睾丸癌(OR=1.4;95%CI=1.1-1.7),膀胱癌(OR=1.1;95%CI=1.1-1.2),乳腺癌(OR=1.4;95%CI=1.3-1.4),外阴白斑(OR=253.5;95%CI=221.9-289.6),和阴茎白斑(OR=5.1;95%CI=4.9-5.4)。结论:这项研究强调了LS患者中各种癌症和癌前病变之间的关联显着增加,强调了对有效治疗和勤奋随访的迫切需要。LS与自身免疫性疾病之间的关联进一步需要进行全面的调查以了解潜在的机制和临床管理意义。未来的研究对于证实这些发现和阐明LS在癌症发展中的作用至关重要。
Background: Data on the incidence and comorbidity of Lichen sclerosus (LS), based on validated nationwide population-based registries, remains scarce. Objective: To explore the incidence and association of comorbidities with LS in Sweden, emphasizing its potential links to malignancies and autoimmune disorders. Methods: A population-based retrospective open cohort
study was conducted using the National Patient Register to identify all individuals diagnosed with LS (ICD-10 code L90.0) from 1 January 2001 to 1 January 2021. The
study included 154,424 LS patients and a sex and age matched control group of 463,273 individuals to assess the incidence and odds ratios for various cancers and premalignant conditions. Results: The incidence of LS in Sweden was 80.9 per 100,000 person per year, with higher incidence in females (114.4) than in males (47.2). LS patients showed an increased odds ratio for vulvar cancer (OR = 8.3; 95% CI = 7.5-9.0), penile cancer (OR = 8.9; 95% CI = 7.3-11.0), prostate cancer (OR = 1.2; 95% CI = 1.1-1.2), testicular cancer (OR = 1.4; 95% CI = 1.1-1.7), bladder cancer (OR = 1.1; 95% CI = 1.1-1.2), breast cancer (OR = 1.4; 95% CI = 1.3-1.4), leukoplakia of the vulva (OR = 253.5; 95% CI = 221.9-289.6), and leukoplakia of the penis (OR = 5.1; 95% CI = 4.9-5.4). Conclusions: This
study underscores the significantly increased association of various cancers and premalignant conditions in LS patients, highlighting the critical need for efficacious treatment and diligent follow-up. The association between LS and autoimmune diseases further necessitates comprehensive investigation to understand the underlying mechanisms and clinical management implications. Future research is essential to confirm these findings and elucidate the role of LS in cancer development.