Association between malignancies and Marfan syndrome: A population-based, nested case-control study in Taiwan

Chin Wang Hsu, Jen Chun Wang, Wen I. Liao, Wu Chien Chien, Chi Hsiang Chung, Chang Huei Tsao, Yung Fu Wu, Min Tser Liao, Shih Hung Tsai

研究成果: 雜誌貢獻文章

2 引文 (Scopus)

摘要

Objective Marfan syndrome (MFS) involves a deficiency of the structural extracellular matrix component fibrillin-1 and overactivation of the transforming growth factor-β (TGF-β) signalling pathway. The TGF-β signalling pathway also actively participates in malignant transformation. Although anecdotal case reports have suggested associations between MFS/MFS-like conditions and several haematological and solid malignancies, such associations have not been thoroughly evaluated in large-scale studies. We sought to use a nationwide healthcare insurance claim database to evaluate whether patients with MFS are at increased risk of malignancy. Patients and methods We conducted a nested case-control analysis using a database extracted from Taiwan's National Health Insurance Research Database. All medical conditions for each case and control were categorised using the International Classification of Diseases, 9th Revision classifications. ORs and 95% CIs for associations between MFS and malignancies were estimated using conditional logistic regression and adjusted for comorbidities. Results Our analyses included 1 153 137 cancer cases and 1 153 137 propensity score-matched controls. Relative to other subjects, patients with MFS had a significantly higher risk of having a malignancy (adjusted OR 3.991) and hypertension (adjusted OR 1.964) and were significantly more likely to be men. Malignancies originating from the head and neck and the urinary tract were significantly more frequent among patients with MFS than among subjects without MFS. Conclusion Patients with MFS are at increased risk of developing various malignancies. Healthcare professionals should be aware of this risk when treating such patients, and increased cancer surveillance may be necessary for these patients.

原文英語
文章編號e017243
期刊BMJ Open
7
發行號10
DOIs
出版狀態已發佈 - 十月 1 2017

指紋

Marfan Syndrome
Taiwan
Case-Control Studies
Population
Neoplasms
Transforming Growth Factors
Databases
Delivery of Health Care
Propensity Score
National Health Programs
International Classification of Diseases
Hematologic Neoplasms
Insurance
Urinary Tract
Extracellular Matrix
Comorbidity
Neck
Logistic Models
Head
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Hsu, C. W., Wang, J. C., Liao, W. I., Chien, W. C., Chung, C. H., Tsao, C. H., ... Tsai, S. H. (2017). Association between malignancies and Marfan syndrome: A population-based, nested case-control study in Taiwan. BMJ Open, 7(10), [e017243]. https://doi.org/10.1136/bmjopen-2017-017243

Association between malignancies and Marfan syndrome : A population-based, nested case-control study in Taiwan. / Hsu, Chin Wang; Wang, Jen Chun; Liao, Wen I.; Chien, Wu Chien; Chung, Chi Hsiang; Tsao, Chang Huei; Wu, Yung Fu; Liao, Min Tser; Tsai, Shih Hung.

於: BMJ Open, 卷 7, 編號 10, e017243, 01.10.2017.

研究成果: 雜誌貢獻文章

Hsu, CW, Wang, JC, Liao, WI, Chien, WC, Chung, CH, Tsao, CH, Wu, YF, Liao, MT & Tsai, SH 2017, 'Association between malignancies and Marfan syndrome: A population-based, nested case-control study in Taiwan', BMJ Open, 卷 7, 編號 10, e017243. https://doi.org/10.1136/bmjopen-2017-017243
Hsu, Chin Wang ; Wang, Jen Chun ; Liao, Wen I. ; Chien, Wu Chien ; Chung, Chi Hsiang ; Tsao, Chang Huei ; Wu, Yung Fu ; Liao, Min Tser ; Tsai, Shih Hung. / Association between malignancies and Marfan syndrome : A population-based, nested case-control study in Taiwan. 於: BMJ Open. 2017 ; 卷 7, 編號 10.
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abstract = "Objective Marfan syndrome (MFS) involves a deficiency of the structural extracellular matrix component fibrillin-1 and overactivation of the transforming growth factor-β (TGF-β) signalling pathway. The TGF-β signalling pathway also actively participates in malignant transformation. Although anecdotal case reports have suggested associations between MFS/MFS-like conditions and several haematological and solid malignancies, such associations have not been thoroughly evaluated in large-scale studies. We sought to use a nationwide healthcare insurance claim database to evaluate whether patients with MFS are at increased risk of malignancy. Patients and methods We conducted a nested case-control analysis using a database extracted from Taiwan's National Health Insurance Research Database. All medical conditions for each case and control were categorised using the International Classification of Diseases, 9th Revision classifications. ORs and 95{\%} CIs for associations between MFS and malignancies were estimated using conditional logistic regression and adjusted for comorbidities. Results Our analyses included 1 153 137 cancer cases and 1 153 137 propensity score-matched controls. Relative to other subjects, patients with MFS had a significantly higher risk of having a malignancy (adjusted OR 3.991) and hypertension (adjusted OR 1.964) and were significantly more likely to be men. Malignancies originating from the head and neck and the urinary tract were significantly more frequent among patients with MFS than among subjects without MFS. Conclusion Patients with MFS are at increased risk of developing various malignancies. Healthcare professionals should be aware of this risk when treating such patients, and increased cancer surveillance may be necessary for these patients.",
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AU - Chung, Chi Hsiang

AU - Tsao, Chang Huei

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N2 - Objective Marfan syndrome (MFS) involves a deficiency of the structural extracellular matrix component fibrillin-1 and overactivation of the transforming growth factor-β (TGF-β) signalling pathway. The TGF-β signalling pathway also actively participates in malignant transformation. Although anecdotal case reports have suggested associations between MFS/MFS-like conditions and several haematological and solid malignancies, such associations have not been thoroughly evaluated in large-scale studies. We sought to use a nationwide healthcare insurance claim database to evaluate whether patients with MFS are at increased risk of malignancy. Patients and methods We conducted a nested case-control analysis using a database extracted from Taiwan's National Health Insurance Research Database. All medical conditions for each case and control were categorised using the International Classification of Diseases, 9th Revision classifications. ORs and 95% CIs for associations between MFS and malignancies were estimated using conditional logistic regression and adjusted for comorbidities. Results Our analyses included 1 153 137 cancer cases and 1 153 137 propensity score-matched controls. Relative to other subjects, patients with MFS had a significantly higher risk of having a malignancy (adjusted OR 3.991) and hypertension (adjusted OR 1.964) and were significantly more likely to be men. Malignancies originating from the head and neck and the urinary tract were significantly more frequent among patients with MFS than among subjects without MFS. Conclusion Patients with MFS are at increased risk of developing various malignancies. Healthcare professionals should be aware of this risk when treating such patients, and increased cancer surveillance may be necessary for these patients.

AB - Objective Marfan syndrome (MFS) involves a deficiency of the structural extracellular matrix component fibrillin-1 and overactivation of the transforming growth factor-β (TGF-β) signalling pathway. The TGF-β signalling pathway also actively participates in malignant transformation. Although anecdotal case reports have suggested associations between MFS/MFS-like conditions and several haematological and solid malignancies, such associations have not been thoroughly evaluated in large-scale studies. We sought to use a nationwide healthcare insurance claim database to evaluate whether patients with MFS are at increased risk of malignancy. Patients and methods We conducted a nested case-control analysis using a database extracted from Taiwan's National Health Insurance Research Database. All medical conditions for each case and control were categorised using the International Classification of Diseases, 9th Revision classifications. ORs and 95% CIs for associations between MFS and malignancies were estimated using conditional logistic regression and adjusted for comorbidities. Results Our analyses included 1 153 137 cancer cases and 1 153 137 propensity score-matched controls. Relative to other subjects, patients with MFS had a significantly higher risk of having a malignancy (adjusted OR 3.991) and hypertension (adjusted OR 1.964) and were significantly more likely to be men. Malignancies originating from the head and neck and the urinary tract were significantly more frequent among patients with MFS than among subjects without MFS. Conclusion Patients with MFS are at increased risk of developing various malignancies. Healthcare professionals should be aware of this risk when treating such patients, and increased cancer surveillance may be necessary for these patients.

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