系统免疫性疾病女性患者宫颈癌及癌前病变的风险研究  

Risk assessment of female patients with inflammatory diseases for cervical cancer and cervical precancerous lesion

作　　者：张延玲[1] 高燕云[1] 

机构地区：[1]榆林市第一医院妇产科一病区,陕西榆林719000

出　　处：《中国性科学》2017年第6期38-41,共4页Chinese Journal of Human Sexuality

摘　　要：目的:对炎性肠病、牛皮癣、类风湿关节炎和系统性红斑狼疮患者宫颈癌及癌前病变的潜在风险进行评估。方法:将来我院就诊的893例系统免疫性疾病患者和420例非系统免疫性疾病患者作为研究对象,通过多变量Cox比例风险模型进行统计分析,探讨系统免疫性疾病与宫颈癌及癌前病变发生和发展的关系。结果:系统免疫性疾病组宫颈癌及癌前病变的发病率是1.01%,其中系统性红斑狼疮患者具有最高的宫颈癌及癌前病变的发病率(1.67%),牛皮癣患者有最低的发病率(0.83%),炎性肠病和类风湿性关节炎的发病率分别为1.01%和0.84%;非炎症患者宫颈癌及癌前病变的发病率为0.73%。基于多变量Cox比例风险模型,炎性肠病的危险比率为1.07(95%CI:0.79~1.45),牛皮癣的危险比率为0.96(95%CI:0.73~1.27),类风湿性关节炎的危险比率为1.49(95%CI:1.11~2.00),系统性红斑狼疮的危险比率为1.53(95%CI:1.07~2.19)。结论:类风湿性关节炎和系统性红斑狼疮患者宫颈癌及癌前病变的风险比非炎症女性患者高1.5倍。免疫抑制剂和类固醇药物的使用可能会增加炎性肠病患者罹患宫颈癌及癌前病变的风险。Objectives： To assess the risk of high-grade cervical dysplasia and cervical cancer in women with SID,inflammatory bowel disease（IBD）,psoriasis,rheumatoid arthritis（RA） or systemic lupus erythematosus（SLE）. Methods： Based on the multivariable Cox models analysis,a cohort study of 893 women with SID and 420 women without SID was conducted to investigate the relationship between the high-grade cervical dysplasia and cervical cancer in women with SID. Results： The crude incidence rate of high-grade cervical dysplasia and cervical cancer for all female patients with systematic inflammatory disease was 1. 01%. The crude incidence rate of high-grade cervical dysplasia and cervical cancer was the highest at 1. 67% in SLE and the lowest at 0. 83% in psoriasis among women with SID,1. 01% and 0. 84% in IBD and RA respectively. The crude incidence rate was at 0. 73%in women without SID. The multivariable HR adjusted for potential confounders was 1. 07（95% CI 0. 79 to 1. 45）in IBD,0. 96（95% CI 0. 73 to 1. 27） in psoriasis,1. 49（95% CI 1. 11 to 2. 00） in RA and 1. 53（95% CI 1. 07 to 2. 19） in SLE. Conclusion： The risk of high-grade cervical dysplasia and cervical cancer is 1. 5 times higher in women with RA and SLE than that in those without SID. The risk may be increased in IBD patients with use of systemic immunosuppressive drugs or steroids.

关 键 词：炎性肠病 牛皮癣 类风湿性关节炎 系统性红斑狼疮 系统性炎症 宫颈癌 风险研究 

分 类 号：R737.33[医药卫生—肿瘤]