儿童时期接受生长激素治疗的患者的癌症风险:SAGhE欧洲队列研究

A. Swerdlow, Rosie Cooke, D. Beckers, B. Borgström, G. Butler, J. Carel, S. Cianfarani, P. Clayton, J. Coste, A. Deodati, E. Ecosse, R. Gausche, C. Giacomozzi, A. Hokken-Koelega, Aysha J. Khan, W. Kiess, C. Kuehni, P. Mullis, R. Pfaffle, L. Sävendahl, G. Sommer, Muriel Thomas, Anders Tidblad, S. Tollerfield, L. van Eycken, G. Zandwijken
{"title":"儿童时期接受生长激素治疗的患者的癌症风险:SAGhE欧洲队列研究","authors":"A. Swerdlow, Rosie Cooke, D. Beckers, B. Borgström, G. Butler, J. Carel, S. Cianfarani, P. Clayton, J. Coste, A. Deodati, E. Ecosse, R. Gausche, C. Giacomozzi, A. Hokken-Koelega, Aysha J. Khan, W. Kiess, C. Kuehni, P. Mullis, R. Pfaffle, L. Sävendahl, G. Sommer, Muriel Thomas, Anders Tidblad, S. Tollerfield, L. van Eycken, G. Zandwijken","doi":"10.1210/jc.2016-2046","DOIUrl":null,"url":null,"abstract":"Context\nGrowth hormone (GH) is prescribed for an increasing range of indications, but there has been concern that it might raise cancer risk. Published data are limited.\n\n\nObjective\nTo examine cancer risks in relation to GH treatment.\n\n\nDesign\nCohort study.\n\n\nSetting\nPopulation-based.\n\n\nPatients\nCohort of 23,984 patients treated with recombinant human GH (r-hGH) in eight European countries since this treatment was first used in 1984. Cancer expectations from country-specific national population statistics.\n\n\nMain Outcome Measures\nCancer incidence and cancer mortality.\n\n\nResults\nIncidence and mortality risks in the cohort were raised for several cancer sites, largely consequent on second primary malignancies in patients given r-hGH after cancer treatment. There was no clear raised risk in patients with growth failure without other major disease. Only for bone and bladder cancers was incidence significantly raised in GH-treated patients without previous cancer. Cancer risk was unrelated to duration or cumulative dose of r-hGH treatment, but for patients treated after previous cancer, cancer mortality risk increased significantly with increasing daily r-hGH dose (P trend < 0.001). Hodgkin lymphoma (HL) incidence increased significantly with longer follow-up (P trend = 0.001 for patients overall and 0.002 for patients without previous cancer).\n\n\nConclusions\nOur results do not generally support a carcinogenic effect of r-hGH, but the unexplained trend in cancer mortality risk in relation to GH dose in patients with previous cancer, and the indication of possible effects on bone cancer, bladder cancer, and HL risks, need further investigation.","PeriodicalId":22632,"journal":{"name":"The Journal of Clinical Endocrinology & Metabolism","volume":"19 1","pages":"1661–1672"},"PeriodicalIF":0.0000,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"112","resultStr":"{\"title\":\"Cancer Risks in Patients Treated With Growth Hormone in Childhood: The SAGhE European Cohort Study\",\"authors\":\"A. Swerdlow, Rosie Cooke, D. Beckers, B. Borgström, G. Butler, J. Carel, S. Cianfarani, P. Clayton, J. Coste, A. Deodati, E. Ecosse, R. Gausche, C. Giacomozzi, A. Hokken-Koelega, Aysha J. Khan, W. Kiess, C. Kuehni, P. Mullis, R. Pfaffle, L. Sävendahl, G. Sommer, Muriel Thomas, Anders Tidblad, S. Tollerfield, L. van Eycken, G. Zandwijken\",\"doi\":\"10.1210/jc.2016-2046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Context\\nGrowth hormone (GH) is prescribed for an increasing range of indications, but there has been concern that it might raise cancer risk. Published data are limited.\\n\\n\\nObjective\\nTo examine cancer risks in relation to GH treatment.\\n\\n\\nDesign\\nCohort study.\\n\\n\\nSetting\\nPopulation-based.\\n\\n\\nPatients\\nCohort of 23,984 patients treated with recombinant human GH (r-hGH) in eight European countries since this treatment was first used in 1984. Cancer expectations from country-specific national population statistics.\\n\\n\\nMain Outcome Measures\\nCancer incidence and cancer mortality.\\n\\n\\nResults\\nIncidence and mortality risks in the cohort were raised for several cancer sites, largely consequent on second primary malignancies in patients given r-hGH after cancer treatment. There was no clear raised risk in patients with growth failure without other major disease. Only for bone and bladder cancers was incidence significantly raised in GH-treated patients without previous cancer. Cancer risk was unrelated to duration or cumulative dose of r-hGH treatment, but for patients treated after previous cancer, cancer mortality risk increased significantly with increasing daily r-hGH dose (P trend < 0.001). Hodgkin lymphoma (HL) incidence increased significantly with longer follow-up (P trend = 0.001 for patients overall and 0.002 for patients without previous cancer).\\n\\n\\nConclusions\\nOur results do not generally support a carcinogenic effect of r-hGH, but the unexplained trend in cancer mortality risk in relation to GH dose in patients with previous cancer, and the indication of possible effects on bone cancer, bladder cancer, and HL risks, need further investigation.\",\"PeriodicalId\":22632,\"journal\":{\"name\":\"The Journal of Clinical Endocrinology & Metabolism\",\"volume\":\"19 1\",\"pages\":\"1661–1672\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"112\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of Clinical Endocrinology & Metabolism\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1210/jc.2016-2046\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of Clinical Endocrinology & Metabolism","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1210/jc.2016-2046","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 112

摘要

生长激素(GH)被用于越来越多的适应症,但人们一直担心它可能会增加患癌症的风险。发表的数据有限。目的探讨生长激素治疗与肿瘤风险的关系。DesignCohort study.SettingPopulation-based。自1984年首次使用重组人生长激素(r-hGH)治疗以来,8个欧洲国家的23,984例患者的患者记录。根据具体国家人口统计得出的癌症预期。主要结局指标:癌症发病率和癌症死亡率。结果该队列中几个癌症部位的发病率和死亡率风险升高,主要是由于癌症治疗后给予r-hGH的患者出现第二原发恶性肿瘤。在没有其他主要疾病的生长衰竭患者中没有明显的风险增加。只有骨癌和膀胱癌的发病率在没有既往癌症的gh治疗患者中显著升高。癌症风险与r-hGH治疗的持续时间或累积剂量无关,但对于既往癌症后接受治疗的患者,癌症死亡风险随着r-hGH每日剂量的增加而显著增加(P趋势< 0.001)。霍奇金淋巴瘤(HL)的发病率随着随访时间的延长而显著增加(总体患者P趋势= 0.001,既往无癌症患者P趋势= 0.002)。结论我们的研究结果并不普遍支持r-hGH的致癌作用,但在既往癌症患者中,肿瘤死亡风险与GH剂量之间的不明趋势,以及对骨癌、膀胱癌和HL风险的可能影响,需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Cancer Risks in Patients Treated With Growth Hormone in Childhood: The SAGhE European Cohort Study
Context Growth hormone (GH) is prescribed for an increasing range of indications, but there has been concern that it might raise cancer risk. Published data are limited. Objective To examine cancer risks in relation to GH treatment. Design Cohort study. Setting Population-based. Patients Cohort of 23,984 patients treated with recombinant human GH (r-hGH) in eight European countries since this treatment was first used in 1984. Cancer expectations from country-specific national population statistics. Main Outcome Measures Cancer incidence and cancer mortality. Results Incidence and mortality risks in the cohort were raised for several cancer sites, largely consequent on second primary malignancies in patients given r-hGH after cancer treatment. There was no clear raised risk in patients with growth failure without other major disease. Only for bone and bladder cancers was incidence significantly raised in GH-treated patients without previous cancer. Cancer risk was unrelated to duration or cumulative dose of r-hGH treatment, but for patients treated after previous cancer, cancer mortality risk increased significantly with increasing daily r-hGH dose (P trend < 0.001). Hodgkin lymphoma (HL) incidence increased significantly with longer follow-up (P trend = 0.001 for patients overall and 0.002 for patients without previous cancer). Conclusions Our results do not generally support a carcinogenic effect of r-hGH, but the unexplained trend in cancer mortality risk in relation to GH dose in patients with previous cancer, and the indication of possible effects on bone cancer, bladder cancer, and HL risks, need further investigation.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Efficacy and safety of targeted therapy for radioiodine-refractory differentiated thyroid cancer: a meta-analysis. Treatment Preferences in Patients with Hypothyroidism: an Analysis of Eleven Randomized Controlled Trials. Metabolomics: A Promising Tool in the Prevention, Diagnosis, and Treatment of Obesity. Association between papillary thyroid cancer and primary aldosteronism in individuals with hypertension. The changing treatment paradigm in prolactinoma - a prospective series of 100 consecutive neurosurgical cases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1