α-1抗胰蛋白酶缺乏症与皮肤癌，白血病和肝癌的风险增加相关：一项全国范围的队列研究
Alpha-1 antitrypsin deficiency associated with increased risks of skin cancer, leukemia, and hepatic cancer: A nationwide cohort study
影响因子:9.20000
分区:医学1区 Top / 医学：内科2区
发表日期:2024 Dec
作者:
Nanna J Korsbæk, Eskild M Landt, Sarah C W Marott, Børge G Nordestgaard, Gabrielle R Vinding, Gregor B E Jemec, Morten Dahl
摘要
α1-抗胰蛋白酶缺乏的特征是弹性酶活性升高和弹性蛋白过度降解，这可能会影响癌症的发育和进展。我们检验了以下假设：丹麦人群中患有α1-抗抑制蛋白缺乏症的个体对癌症的敏感性增加了。在一项全国性的嵌套研究中，我们确定了2702个患有α1-抗抗抑制蛋白缺乏症的个体，而没有α1-抗抗抑制剂缺乏症的人，与年龄，性别，性别，性别，性别，性别，性别，性别，性别，和uniaciplation。 We recorded admissions due to cancer as outcomes during a median follow-up of 62 years.Individuals with α1-antitrypsin deficiency versus control subjects had an increased hazard of skin cancer (2.18, 95%CI: 1.81-2.63), leukemia (1.76, 1.12-2.79), liver cancer (3.91, 2.23-6.85), and cancer overall (1.25, 1.13-1.38）。当将整个丹麦人口用作对照组时，相应的危险比为3.02（2.55-3.58），1.83（1.19-2.81），4.46（2.74-7.28）和1.45（1.31-1.59）。当根据合并症对分析进行分层时，慢性阻塞性肺疾病（COPD）（3.59，2.60-4.95）和皮肤病（2.93，2.19-3.92）的皮肤癌危害更高，但没有任何这些疾病的人仍保持升高。当通过肝硬化和缺血性心脏病分层时，患有α1-抗胰蛋白酶缺乏症患者皮肤癌的危害相似（PS相互作用：≥0.76）。根据肝肝硬化，COPD，皮肤病和缺血性心脏病（PS进行相互作用：≥0.13），与α1-抗抑制蛋白缺乏的独立性相似，患有α1-抗抑制蛋白缺乏与对照受试者患者的肝癌的危害相似。
Abstract
α1-Antitrypsin deficiency is characterized by elevated elastase activity and excessive elastin degradation, which may impact cancer development and progression. We tested the hypothesis that individuals with α1-antitrypsin deficiency have increased susceptibility to cancer in the Danish population.In a nationwide nested study, we identified 2702 individuals with α1-antitrypsin deficiency and 26,750 control subjects without α1-antitrypsin deficiency matched on age, sex, and municipality. We recorded admissions due to cancer as outcomes during a median follow-up of 62 years.Individuals with α1-antitrypsin deficiency versus control subjects had an increased hazard of skin cancer (2.18, 95%CI: 1.81-2.63), leukemia (1.76, 1.12-2.79), liver cancer (3.91, 2.23-6.85), and cancer overall (1.25, 1.13-1.38). Corresponding hazard ratios when the entire Danish population was used as control group were 3.02 (2.55-3.58), 1.83 (1.19-2.81), 4.46 (2.74-7.28), and 1.45 (1.31-1.59). When the analysis was stratified according to comorbidities, the hazard for skin cancer was higher in those with chronic obstructive pulmonary disease (COPD) (3.59, 2.60-4.95) and skin disease (2.93, 2.19-3.92) but remained elevated in those without any of these diseases. Hazards for skin cancer in individuals with α1-antitrypsin deficiency were similar when stratified by liver cirrhosis and ischemic heart disease (ps for interaction: ≥0.76). Hazards for liver cancer in individuals with α1-antitrypsin deficiency versus control subjects were similar when stratified according to liver cirrhosis, COPD, skin disease, and ischemic heart disease (ps for interaction: ≥0.13).Individuals with α1-antitrypsin deficiency have increased risks of skin cancer, leukemia, and liver cancer in the Danish population.