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首页> 外文期刊>The American Journal of Gastroenterology >Risk of melanoma and non-melanoma skin cancer in ulcerative colitis patients treated with Thiopurines: A nationwide retrospective cohort
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Risk of melanoma and non-melanoma skin cancer in ulcerative colitis patients treated with Thiopurines: A nationwide retrospective cohort

机译:黑色素瘤和非黑色素瘤皮肤癌的风险含有硫疗治疗的溃疡性结肠炎患者:全国回顾性队列

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摘要

OBJECTIVES:There are limited data on the risk of non-melanoma skin cancer (NMSC) and melanoma skin cancer (MSC) among thiopurine-Treated patients with ulcerative colitis (UC). Our aim was to investigate the risk while on, by cumulative years, and after stopping thiopurine therapy.METHODS:Nationwide data were obtained from the Veterans Affairs (VA) health-care system during 2001-2011. We performed a retrospective cohort study evaluating patients with UC. Cox regression was used to investigate the association between thiopurines use and time to NMSC while adjusting for demographics, ultraviolet radiation exposure, and VA visiting frequency. A matched nested case-control study was conducted to investigate the association between thiopurine use and MSC.RESULTS:We included 14,527 patients with UC in the analysis, with a median follow-up of 8.1 years. A total of 3,346 (23%) patients used thiopurines for a median duration of 1.6 years. We identified 421 NMSC and 45 MSC cases. The adjusted hazard ratios of developing NMSC while on and after stopping thiopurines were 2.1 (P<0.0001) and 0.7 (P=0.07), respectively, as compared with unexposed patients. The incidence rate of NMSC among those who never used thiopurines was 3.7 compared with 5.8, 7.9, 8.3, 7.8, and 13.6 per 1,000 person-years for the 1st, 2nd, 3th, 4th, and 5th year of thiopurine use, respectively. No statistically significant association was observed between thiopurine use and MSC, odds ratio 0.8 (P=0.6).CONCLUSIONS:In this predominantly white male nationwide cohort, there was a twofold increase in the risk of NMSC while on thiopurines. The incidence rate of NMSC significantly increased with subsequent years of cumulative exposure to thiopurines. Stopping thiopurines reduced the risk of NMSC to pre-exposure levels irrespective of the prior exposure duration.
机译:目的:有关硫孔治疗的溃疡性结肠炎(UC)的硫氨酸处理患者中非黑色素瘤皮肤癌(NMSC)和黑色素瘤皮肤癌(MSC)的风险有限。我们的目标是通过累积年来调查风险,累积岁月和停止硫嘌呤治疗。方法:全国数据在2001 - 2011年期间从退伍军人事务(VA)卫生保健系统获得。我们进行了评估UC患者的回顾性队列研究。 Cox回归用于研究硫孔使用和时间与NMSC之间的关联,同时调整人口统计学,紫外线辐射曝光和VA访问频率。进行了匹配的嵌套病例对照研究以研究硫嘌呤使用和MSC.Results之间的关联:我们在分析中包含14,527名UC患者,中位随访8.1年。共有3,346名(23%)患者使用硫嘌呤,中位持续时间为1.6岁。我们确定了421个NMSC和45个MSC案例。与未曝光患者相比,在停止硫嘌呤上和停止硫嘌呤的时和在硫嘌呤的时,在停止硫嘌呤的同时和后的调节危险比分别为2.1(p <0.0001)和0.7(p = 0.07)。 NMSC的发病率分别为3.7的人群,与5.8,7.9,8.3,7.8和1,000人数,分别为硫嘌呤使用的第1,第2,第3,第4和第5岁,7.8%,每1,000人。在硫嘌呤使用和MSC之间没有观察到统计学上显着的关联0.8(p = 0.6)。结论:在这主要是白人全国范围的队列,在硫嘌呤上患NMSC的风险增加了两种。随后累积暴露于硫嘌呤的累积暴露,NMSC的发病率显着增加。停止硫嘌呤,无论先前的暴露持续时间如何,都会将NMSC的风险降低到预曝光水平。

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    Department of Medicine University of Florida 1600 SW Archer RoadGainesville FL United States;

    Department of Epidemiology School of Public Health Louisiana State University Health Science;

    Division of Gastroenterology and Hepatology Department of Internal Medicine Mayo ClinicRochester;

    Philadelphia VA Medical Center Division of Gastroenterology University of Pennsylvania Perelman;

    Department of Medicine University of Florida 1600 SW Archer RoadGainesville FL United States;

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  • 正文语种 eng
  • 中图分类 消化系及腹部疾病;
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