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1.
  • Castro, Felipe A., et al. (författare)
  • Increased Risk of Hepatobiliary Cancers After Hospitalization for Autoimmune Disease
  • 2014
  • Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier BV. - 1542-7714 .- 1542-3565. ; 12:6, s. 1038-1045
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND & AIMS: Some autoimmune diseases are associated with increased risk of liver cancer. However, there has been no comprehensive evaluation of autoimmune diseases among patients who develop different subtypes of hepatobiliary cancer. We examined the association between autoimmune diseases and cancers of the liver and biliary tract in the Swedish population. METHODS: We analyzed data from national datasets at the Center for Primary Health Care Research (Lund University, Sweden). Data on patients with autoimmune disorders were retrieved from the Swedish Hospital Discharge Register, from 1964 through 2008; 33 diseases were evaluated. Hepatobiliary cancer cases were retrieved from the Swedish Cancer Registry. We calculated standardized incidence ratios (SIRs) and hazard ratios for incident cancers and deaths from hepatobiliary cancers. RESULTS: Among 402,462 patients with autoimmune disorders, 582 were diagnosed with primary liver cancer, 330 with gallbladder cancer, 115 with extrahepatic bile duct cancer, and 43 with ampulla of Vater cancers. We identified 14 autoimmune conditions that were significantly associated with increased risk of primary liver cancer (overall SIR [any autoimmune disease], 2.1; 95% confidence interval [CI], 2.0-2.3), 5 conditions associated with gallbladder cancer (overall SIR, 1.3; 95% CI, 1.1-1.4), and 3 associated with extrahepatic bile duct cancer (overall SIR, 1.6; 95% CI, 1.3-1.9). The autoimmune disorders with the strongest association with primary liver cancer were primary biliary cirrhosis (SIR, 39.5; 95% CI, 28.2-53.8) and autoimmune hepatitis (SIR, 29.0; 95% CI, 9.1-68.2); ulcerative colitis was strongly associated with extrahepatic bile duct cancer (SIR, 5.6; 95% CI, 3.6-8.4). Celiac disease, Crohn's disease, systemic sclerosis, and ulcerative colitis were associated with at least 2 types of cancer. Increased hazard ratios were observed only for patients with biliary tract cancer who had been hospitalized for autoimmune conditions. CONCLUSIONS: In a study of the Swedish population, we identified an increased risk of hepatobiliary cancers among individuals diagnosed with autoimmune disease. Associations among different cancer types indicate that shared immunomodulatory mechanisms determine susceptibility to hepatobiliary cancer.
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2.
  • Fallah, Mahdi, et al. (författare)
  • Autoimmune diseases associated with non-Hodgkin lymphoma: A nationwide cohort study.
  • 2014
  • Ingår i: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 25:10, s. 2025-2030
  • Tidskriftsartikel (refereegranskat)abstract
    • The cumulative risk of NHL in Sweden by age 80 years has increased to 1.1 in women and 1.6% in men in 2011. Increased risk of non-Hodgkin lymphoma (NHL) associated with personal histories of some autoimmune diseases (ADs) are known. It is unclear whether there are other NHL-related ADs and whether this association holds across different sex, age and year of diagnosis, or NHL histological subtypes.
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3.
  • Fallah, M., et al. (författare)
  • Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype
  • 2014
  • Ingår i: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 25:7, s. 1397-1404
  • Tidskriftsartikel (refereegranskat)abstract
    • Increased risk of Hodgkin lymphoma (HL) associated with personal history of several autoimmune diseases (ADs), such as rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and immune thrombocytopenic purpura, are known. Whether there are other HL-related ADs and whether the increased risk of HL after ADs holds across sex, age, year of diagnosis, or HL histological subtype is unclear. We systematically analyzed the risk of HL in 878 161 Swedish patients diagnosed with 33 different ADs in 1964-2010. During similar to 10-year follow-up of ADs patients, 371 incident HL cases were diagnosed. Significantly increased overall standardized incidence ratio (SIR) for HL after ADs was 2.0 (95% confidence interval: 1.8-2.2); AD-specific SIRs: autoimmune hemolytic anemia 19.9 (7.2-43.6), sarcoidosis 10.3 (7.8-13.4), systemic lupus erythematosus 8.4 (5.2-12.9), immune thrombocytopenic purpura 7.0 (3.2-13.3), polyarteritis nodosa 6.6 (1.2-19.5), polymyositis/dermatomyositis 6.3 (2.0-14.9), Behcet's disease 5.6 (2.7-10.3), Sjogren's syndrome 5.0 (2.1-9.8), rheumatoid arthritis 3.2 (2.6-3.9), polymyalgia rheumatica 2.2 (1.4-3.5), and psoriasis 1.9 (1.3-2.6). Men with AD had slightly higher risk of HL (2.4, 2.0-2.7) compared with women (1.8, 1.5-2.0). Only 23% of ADs were diagnosed before age 35 years and the overall SIR for HL diagnosis before age 35 [1.4, (1.0-1.8)] was lower than that in older ages [35 a parts per thousand currency sign age < 50: 2.1 (1.6-2.7); age a parts per thousand yen 50: 2.2 (2.0-2.5)], except for sarcoidosis [age < 35: 19.3 (10.5-32.5); 35 a parts per thousand currency sign age < 50: 10.4 (5.7-17.5); age a parts per thousand yen 50: 8.4 (5.6-12.1)]. Risks of all classical HLs significantly increased after ADs: lymphocyte depletion 3.7 (1.5-7.6), lymphocyte-rich 3.7 (2.3-5.9), mixed cellularity 2.4 (1.8-3.2), and nodular sclerosis 1.7 (1.3-2.1). Several, but not all ADs (11/33), had a positive association with all classical histological subtypes of HL. Higher risks of classical HL after polyarteritis nodosa, polymyositis/dermatomyositis, Behcet's disease, Sjogren's syndrome, polymyalgia rheumatica, and psoriasis were novel findings of this study.
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4.
  • Gross, Franz, et al. (författare)
  • 50 Years of quantum chromodynamics : Introduction and Review
  • 2023
  • Ingår i: European Physical Journal C. - 1434-6044. ; 83:12
  • Forskningsöversikt (refereegranskat)abstract
    • Quantum Chromodynamics, the theory of quarks and gluons, whose interactions can be described by a local SU(3) gauge symmetry with charges called “color quantum numbers”, is reviewed; the goal of this review is to provide advanced Ph.D. students a comprehensive handbook, helpful for their research. When QCD was “discovered” 50 years ago, the idea that quarks could exist, but not be observed, left most physicists unconvinced. Then, with the discovery of charmonium in 1974 and the explanation of its excited states using the Cornell potential, consisting of the sum of a Coulomb-like attraction and a long range linear confining potential, the theory was suddenly widely accepted. This paradigm shift is now referred to as the November revolution. It had been anticipated by the observation of scaling in deep inelastic scattering, and was followed by the discovery of gluons in three-jet events. The parameters of QCD include the running coupling constant, αs(Q2) , that varies with the energy scale Q2 characterising the interaction, and six quark masses. QCD cannot be solved analytically, at least not yet, and the large value of αs at low momentum transfers limits perturbative calculations to the high-energy region where Q2≫ΛQCD2≃ (250 MeV) 2 . Lattice QCD (LQCD), numerical calculations on a discretized space-time lattice, is discussed in detail, the dynamics of the QCD vacuum is visualized, and the expected spectra of mesons and baryons are displayed. Progress in lattice calculations of the structure of nucleons and of quantities related to the phase diagram of dense and hot (or cold) hadronic matter are reviewed. Methods and examples of how to calculate hadronic corrections to weak matrix elements on a lattice are outlined. The wide variety of analytical approximations currently in use, and the accuracy of these approximations, are reviewed. These methods range from the Bethe–Salpeter, Dyson–Schwinger coupled relativistic equations, which are formulated in both Minkowski or Euclidean spaces, to expansions of multi-quark states in a set of basis functions using light-front coordinates, to the AdS/QCD method that imbeds 4-dimensional QCD in a 5-dimensional deSitter space, allowing confinement and spontaneous chiral symmetry breaking to be described in a novel way. Models that assume the number of colors is very large, i.e. make use of the large Nc -limit, give unique insights. Many other techniques that are tailored to specific problems, such as perturbative expansions for high energy scattering or approximate calculations using the operator product expansion are discussed. The very powerful effective field theory techniques that are successful for low energy nuclear systems (chiral effective theory), or for non-relativistic systems involving heavy quarks, or the treatment of gluon exchanges between energetic, collinear partons encountered in jets, are discussed. The spectroscopy of mesons and baryons has played an important historical role in the development of QCD. The famous X,Y,Z states – and the discovery of pentaquarks – have revolutionized hadron spectroscopy; their status and interpretation are reviewed as well as recent progress in the identification of glueballs and hybrids in light-meson spectroscopy. These exotic states add to the spectrum of expected qq¯ mesons and qqq baryons. The progress in understanding excitations of light and heavy baryons is discussed. The nucleon as the lightest baryon is discussed extensively, its form factors, its partonic structure and the status of the attempt to determine a three-dimensional picture of the parton distribution. An experimental program to study the phase diagram of QCD at high temperature and density started with fixed target experiments in various laboratories in the second half of the 1980s, and then, in this century, with colliders. QCD thermodynamics at high temperature became accessible to LQCD, and numerical results on chiral and deconfinement transitions and properties of the deconfined and chirally restored form of strongly interacting matter, called the Quark–Gluon Plasma (QGP), have become very precise by now. These results can now be confronted with experimental data that are sensitive to the nature of the phase transition. There is clear evidence that the QGP phase is created. This phase of QCD matter can already be characterized by some properties that indicate, within a temperature range of a few times the pseudocritical temperature, the medium behaves like a near ideal liquid. Experimental observables are presented that demonstrate deconfinement. High and ultrahigh density QCD matter at moderate and low temperatures shows interesting features and new phases that are of astrophysical relevance. They are reviewed here and some of the astrophysical implications are discussed. Perturbative QCD and methods to describe the different aspects of scattering processes are discussed. The primary parton–parton scattering in a collision is calculated in perturbative QCD with increasing complexity. The radiation of soft gluons can spoil the perturbative convergence, this can be cured by resummation techniques, which are also described here. Realistic descriptions of QCD scattering events need to model the cascade of quark and gluon splittings until hadron formation sets in, which is done by parton showers. The full event simulation can be performed with Monte Carlo event generators, which simulate the full chain from the hard interaction to the hadronic final states, including the modelling of non-perturbative components. The contribution of the LEP experiments (and of earlier collider experiments) to the study of jets is reviewed. Correlations between jets and the shape of jets had allowed the collaborations to determine the “color factors” – invariants of the SU(3) color group governing the strength of quark–gluon and gluon–gluon interactions. The calculated jet production rates (using perturbative QCD) are shown to agree precisely with data, for jet energies spanning more than five orders of magnitude. The production of jets recoiling against a vector boson, W± or Z, is shown to be well understood. The discovery of the Higgs boson was certainly an important milestone in the development of high-energy physics. The couplings of the Higgs boson to massive vector bosons and fermions that have been measured so far support its interpretation as mass-generating boson as predicted by the Standard Model. The study of the Higgs boson recoiling against hadronic jets (without or with heavy flavors) or against vector bosons is also highlighted. Apart from the description of hard interactions taking place at high energies, the understanding of “soft QCD” is also very important. In this respect, Pomeron – and Odderon – exchange, soft and hard diffraction are discussed. Weak decays of quarks and leptons, the quark mixing matrix and the anomalous magnetic moment of the muon are processes which are governed by weak interactions. However, corrections by strong interactions are important, and these are reviewed. As the measured values are incompatible with (most of) the predictions, the question arises: are these discrepancies first hints for New Physics beyond the Standard Model? This volume concludes with a description of future facilities or important upgrades of existing facilities which improve their luminosity by orders of magnitude.
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5.
  • Hemminki, Kari, et al. (författare)
  • Autoimmune disease and subsequent digestive tract cancer by histology
  • 2012
  • Ingår i: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 23:4, s. 6-927
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Dysregulation of the immune function in autoimmune diseases could potentially lead to cancer development and there is definite evidence linking some autoimmune mechanisms with cancer. We analyzed systematically the occurrence of histology-specific digestive tract cancers in patients diagnosed with 33 different autoimmune diseases in order to address the question of shared susceptibility. Patients and methods: Standardized incidence ratios (SIRs) were calculated for subsequent digestive tract cancers up to the year 2008 and in patients hospitalized for autoimmune disease after the year 1964. Results: Myasthenia gravis associated with five different cancers with SIRs ranging from 1.35 to 2.78. Pernicious anemia, Crohn disease, ulcerative colitis, systemic lupus erythematosis and psoriasis were also associated with cancers at multiple sites. Rheumatoid arthritis associated with no cancer and the standardized incidence ratio was decreased for colon adenocarcinoma, also in ankylosing spondylitis patients. Conclusions: Increased risks of cancer were observed in patients with several autoimmune diseases. Myasthenia gravis and pernicious anemia were associated with many cancers; this is possibly related to immunosuppressant medication in myasthenia gravis. The decreased risks in colon and rectal adenocarcinomas in rheumatoid arthritis and ankylosing spondylitis suggest underlying inflammatory mechanisms as the risks may have been suppressed by the use of anti-inflammatory medication.
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6.
  • Hemminki, Kari, et al. (författare)
  • Effect of autoimmune diseases on incidence and survival in subsequent multiple myeloma
  • 2012
  • Ingår i: Journal of Hematology & Oncology. - : Springer Science and Business Media LLC. - 1756-8722. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients with many types of autoimmune diseases (AIDs) are at an increased risk of cancer, which may depend on underlying dysregulation of the immune system or treatment. We systematically analyzed myeloma risk and survival in patients diagnosed with 33 different AIDs. Methods: Data on patients with AIDs were retrieved from the Swedish Hospital Discharge Register and were linked to myeloma diagnoses from the Cancer Registry. Standardized incidence ratios (SIR) and hazard ratios (HRs) were calculated for subsequent myeloma between 1964 and 2008. Results: Among patients with the 33 AIDs analyzed, 457 cases of myeloma were diagnosed. The overall SIR for myeloma was 1.12 and the overall HR was 0.92 and non-significant. SIRs for myeloma were significantly increased after ankylosing spondylitis (2.02) and systemic sclerosis (2.63). Only the HR for myeloma after rheumatic fever (5.27) was significantly increased. The SIR for myeloma before age 60 years was 1.45; the SIR for myeloma was only increased in the period 1964-1990 (1.31) and not later (1.04). Only the SIR for myeloma after ankylosing spondylitis was increased in the period 1991-2008 (2.09); the HRs for myeloma were increased after polymyositis/ dermatomyositis (6.44) and rheumatic fever (4.43) but there were only three deaths of myeloma after these AIDs. Conclusions: The present data showed an increase in myeloma SIR after two AIDs, ankylosing spondylitis and systemic sclerosis, and in HR after rheumatic fever. The overall myeloma risk after any AID was no longer increased in the latter follow-up period of 1991 through 2008.
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7.
  • Hemminki, Kari, et al. (författare)
  • Effect of autoimmune diseases on mortality and survival in subsequent digestive tract cancers
  • 2012
  • Ingår i: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 23:8, s. 2179-2184
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with some autoimmune diseases (AIDs) are at increased risk of cancer, possibly a result of an underlying dysregulation of the immune system, medication, treatment or, probably, surveillance bias. Data on cancer mortality and survival in patients previously diagnosed with AIDs would provide novel information on these comorbidities and their clinical implications. Standardized mortality ratios (SMRs) and hazard ratios (HRs) were calculated for subsequent deaths from seven digestive tract cancers between 1964 and 2008 in patients hospitalized for any of 33 AIDs. There were 33 increased SMRs for specific cancers after a defined AID; similarly, 21 HRs were increased. Both the SMR and HR were increased after 10 autoimmune disorders, including pernicious anemia, systemic lupus erythematosus and psoriasis. Increased SMRs and unchanged HRs were noted for 23 cancers. Myasthenia gravis was associated with SMRs for five cancers but no increases in HRs. For nine cancers, including esophageal cancer after ulcerative colitis and rheumatoid arthritis, the SMR was unchanged but the HR increased. The increases in SMRs provide evidence that cancer risks were truly increased and largely unaffected by surveillance bias. The prognostic survival data should contribute to clinical evaluation and therapeutic planning.
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8.
  • Hemminki, Kari, et al. (författare)
  • Effect of autoimmune diseases on risk and survival in female cancers.
  • 2012
  • Ingår i: Gynecologic Oncology. - : Elsevier BV. - 1095-6859 .- 0090-8258. ; 127:1, s. 180-185
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Patients with autoimmune (AI) diseases are diagnosed with increased frequencies of some cancers, which may depend on the underlying dysregulation of the immune system or treatment. Data on female cancers are limited. METHODS: We analyzed systematically risk and survival of female cancers of the breast, uterus, ovary and other genital organs in close to 200,000 patients diagnosed with any of 33 different AI diseases. Standardized incidence ratios (SIRs) for risk and hazard ratios (HRs) for survival were calculated for subsequent incident cancers or cancer deaths up to year 2008. RESULTS: For all breast cancer after any AI diseases, the SIR was 0.94; SIRs were modestly increased after two AI diseases and decreased after nine AI diseases, including Sjogren syndrome (0.46). For cervical cancer, the risk was increased after discoid lupus erythematosus (3.34) and systemic sclerosis (2.43). The HR was 2.12 in chronic rheumatic heart disease patients. The overall SIR for endometrial cancer was 0.85, with low SIR in ankylosing spondylitis (0.37); the HR was 4.05 for Sjogren syndrome. The SIR for ovarian cancer was increased for polymyositis/dermatomyositis (3.26) while the HR was increased for multiple sclerosis (2.43). The overall SIR for other genital cancers was increased to 1.54 and a very high risk of 35.88 was observed in localized scleroderma. CONCLUSIONS: Breast, endometrial and ovarian cancers were decreased after all AI diseases and most significant changes after individual AI diseases were towards lower risks. Probably treatment related factors explain the findings. For cervical and other genital cancers all significant changes were increased risks.
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9.
  • Hemminki, Kari, et al. (författare)
  • Effect of autoimmune diseases on risk and survival in histology-specific lung cancer
  • 2012
  • Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 40:6, s. 1489-1495
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with autoimmune diseases are at an increased risk of cancer due to underlying dysregulation of the immune system or treatment. Data on cancer incidence, mortality and survival after autoimmune diseases would provide further information on the clinical implications. We systematically analysed data on lung cancer in patients diagnosed with 33 different autoimmune diseases. Standardised incidence ratios (SIRs), standardised mortality ratios (SMRs) and hazard ratios (HRs) were calculated for subsequent incident lung cancers or lung cancer deaths up to 2008 in patients hospitalised for autoimmune disease after 1964. Increased risks of lung cancer were recorded for SIRs after 12 autoimmune diseases, SMRs after 11 autoimmune diseases and HRs after two autoimmune diseases. The highest SIRs and SMRs, respectively, were seen after discoid lupus erythematosus (4.71 and 4.80), polymyosistis/dermatomyositis (4.20 and 4.17), systemic lupus erythematosus (2.47 and 2.69), rheumatic fever (2.07 and 2.07) and systemic sclerosis (2.19 and 1.98). Autoimmune disease did not influence survival overall but some autoimmune diseases appeared to impair survival in small cell carcinoma. All autoimmune diseases that had an SIR >2.0 are known to present with lung manifestations, suggesting that the autoimmune process contributes to lung cancer susceptibility. The data on survival are reassuring that autoimmune diseases do not influence prognosis in lung cancer.
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11.
  • Hemminki, Kari, et al. (författare)
  • Origin of B-cell neoplasms in autoimmune disease
  • 2016
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Autoimmune diseases (ADs) are associated with a number of B-cell neoplasms but the associations are selective in regard to the type of neoplasm and the conferred risks are variable. So far no mechanistic bases for these differential associations have been demonstrated. We speculate that developmental origin of B-cells might propose a mechanistic rationale for their carcinogenic response to autoimmune stimuli and tested the hypothesis on our previous studies on the risks of B-cell neoplasms after any of 33 ADs. We found that predominantly germinal center (GC)-derived B-cells showed multiple associations with ADs: diffuse large B cell lymphoma associated with 15 ADs, follicular lymphoma with 7 ADs and Hodgkin lymphoma with 11 ADs. Notably, these neoplasms shared significant associations with 5 ADs (immune thrombocytopenic purpura, polymyositis/dermatomyositis, rheumatoid arthritis, Sjogren syndrome and systemic lupus erythematosis). By contrast, primarily non-GC neoplasms, acute lymphocytic leukemia, chronic lymphocytic leukemia and myeloma associated with 2 ADs only and mantle cell lymphoma with 1 AD. None of the neoplasms shared associated ADs. These data may suggest that autoimmune stimulation critically interferes with the rapid cell division, somatic hypermutation, class switch recombination and immunological selection of maturing B-cell in the GC and delivers damage contributing to transformation.
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13.
  • Hemminki, Kari, et al. (författare)
  • Subsequent brain tumors in patients with autoimmune disease.
  • 2013
  • Ingår i: Neuro-Oncology. - : Oxford University Press (OUP). - 1523-5866 .- 1522-8517. ; 15:9, s. 1142-1150
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPrevious studies have reported increased risk of brain tumors after allergic conditions, but no systematic analyses of these tumors in patients with autoimmune disease (AId) have been performed. No data are available on survival among patients with AId from brain tumors. We analyzed systematically risks and survival in histological types of brain tumors among patients who received a diagnosis of 33 different AIds.Patients and MethodsStandardized incidence ratios (SIRs) for brain tumors or hazard ratios (HRs) of deaths after brain tumors were calculated up to 2008 in 402 462 patients hospitalized for AId after 1964 and were compared with data on the population not hospitalized for AIds.ResultsBrain tumors were diagnosed in 880 patients with AId. No increased or decreased risks (SIRs) were noted for glioma, whereas the increased SIRs for meningioma after many AIds were likely to be attributable to surveillance bias. The data on survival showed overall decreases for glioma (HR, 1.15) and meningioma (HR, 1.26). The survival in both was decreased in patients with chronic rheumatic heart disease, multiple sclerosis, and rheumatoid arthritis. Overall, HRs were increased for glioma after 6 AIds and for meningioma after 7 AIds.ConclusionsThe present data showed that none of the 33 AIds influenced the risk of glioma. However, many AIds negatively influence survival in glioma and meningioma, probably through added physical burden or therapeutic limitations. Information of an existing AId in patients with newly diagnosed brain tumors should help the prognostic assessment and the design of treatment.
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15.
  • Hemminki, Kari, et al. (författare)
  • Subsequent leukaemia in autoimmune disease patients.
  • 2013
  • Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 161:5, s. 677-687
  • Tidskriftsartikel (refereegranskat)abstract
    • Previous studies have shown that patients diagnosed with some autoimmune (AI) diseases are at an increased risk of leukaemia but limited data are available on survival. We systematically analysed the risks (standardized incidence ratio, SIR) and survival (hazard ratio, HR) in nine types of leukaemia among 402 462 patients hospitalized for any of 33 AI diseases and compared to persons not hospitalized for AI diseases. Risk for all leukaemia was increased after 13 AI diseases and survival was decreased after six AI diseases. SIRs were increased after all AI diseases for seven types of leukaemia, including SIR 1·69 (95% confidence interval (CI): 1·29-2·19) for acute lymphoblastic leukaemia (ALL), 1·85 (95% CI: 1·65-2·07) for acute myeloid leukaemia, 1·68 (95% CI: 1·37-2·04) for chronic myeloid leukaemia, 2·20 (95% CI: 1·69-2·81) for 'other myeloid leukaemia', 2·45 (95% 1·99-2·98) for 'other and unspecified leukaemia', 1·81 (95% CI: 1·11-2·81) for monocytic leukaemia, and 1·36 (95% CI: 1·08-1·69) for myelofibrosis. The HRs were increased for four types of leukaemia, most for myelofibrosis (1·74, 95% CI: 1·33-2·29) and ALL (1·42, 95% CI: 1·03-1·95). Some AI diseases, including rheumatoid arthritis, were associated with increased SIRs and HRs in many types of leukaemia. The present data showed increases in risk and decreases in survival for many types of leukaemia after various AI diseases. Leukaemia is a rare complication in AI disease but findings about this comorbidity at the time of leukaemia diagnosis may help to optimize the treatment and improve survival.
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16.
  • Hemminki, Kari, et al. (författare)
  • Subsequent Type 2 Diabetes in Patients with Autoimmune Disease.
  • 2015
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Immunological data show that type 2 diabetes (T2D) manifests autoimmune features. We wanted to test the association epidemiologically by assessing subsequent diagnosis of T2D following diagnosis of autoimmune disease (AId) and subsequent AId after T2D in the same individuals. Patients were identified from three Swedish health databases. A total of 32 different AId were included. Standardized incidence ratios (SIRs) were calculated for T2D diagnosis in patients with previously diagnosed AId and compared to those without a previous AId. Among a total of 757,368 AId patients, 15,103 were diagnosed with T2D, giving an overall SIR for T2D of 1.66. T2D risks were increased after 27 AIds; the highest SIRs were noted for chorea minor (8.00), lupoid hepatitis (5.75), and Addison disease (2.63). T2D was increased after 27 of 32 AIds but we were unable to control for factors such as obesity and smoking. However, the clearly increased risks for T2D in most types of AId patients, and in reverse order increased risks for AId after T2D, do not support an overall confounding by life-style factors. Mechanistic links shared by T2D, AId and life-style factors such as obesity, perhaps through chronic inflammation, may drive autoimmune activation of T2D and many AIds.
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17.
  • Ji, Jianguang, et al. (författare)
  • Cancer risk in patients hospitalized with polymyalgia rheumatica and giant cell arteritis: a follow-up study in Sweden.
  • 2010
  • Ingår i: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324. ; Apr 8, s. 1158-1163
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives. Studies reporting cancer risk after PMR and GCA are few, but it remains an issue of both concern and controversy. We examined the overall and specific cancer risks among Swedish subjects following hospitalization for these diseases. Methods. PMR and GCA patients were identified from the Swedish Hospital Discharge Register and by linking them with the Cancer Registry. Follow-up of patients was carried out from the last hospitalization through year 2006. Standardized incidence ratios (SIRs) were calculated in these patients compared with subjects without the diseases. Results. A total of 35 918 patients were hospitalized for PMR and GCA during the years 1965-2006; the hospitalization rate increased towards late age. A total of 3941 patients developed subsequent cancer, giving an overall SIR of 1.19; and for cancer diagnosed later than 1 year of follow-up, the SIR was 1.06. A significant excess was noted for skin (squamous cell carcinoma and melanoma), stomach, lung, prostate, kidney, nervous system and endocrine gland tumours, and additionally for non-Hodgkin's lymphoma, myeloma and leukaemia. Decreased risk was noted for endometrial cancer. Conclusions. Patients hospitalized for PMR and GCA had a marginally increased risk of cancer, with the highest risk noted for the first year after hospitalization. However, for specific cancers, such as skin cancer and leukaemia, the increases were still significant for patients diagnosed later than 1 year after hospitalization, suggesting that these could be true associations, but the mechanisms remain to be established.
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18.
  • Ji, Jianguang, et al. (författare)
  • Survival of cancer in patients with rheumatoid arthritis: a follow-up study in Sweden of patients hospitalized with rheumatoid arthritis 1 year before diagnosis of cancer.
  • 2011
  • Ingår i: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324. ; 50, s. 1513-1518
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives. Patients diagnosed with RA have an increased risk of some cancers. However, limited data are available on the important issue of prognosis of RA patients with cancer. Methods. RA patients were identified from the Swedish Hospital Discharge Register by linkage to the Cancer Registry. Follow-up of patients was started from the date of diagnosis of cancer through year 2006. Hazard ratios (HRs) were calculated in cancer patients with RA compared with subjects without RA. Results. A total of 1 411 163 cancer patients were identified in the database, of whom 6309 had a previous hospitalization for RA. Compared with all cancer patients without RA, patients with RA had a worse prognosis, with an HR of 1.29 and 1.31 for cause-specific and overall survival, respectively. For specific cancer sites, skin and breast cancers and non-Hodgkin's lymphoma showed worst survival. Age stratification did not change the results. Conclusion. Cancer patients with a previous hospitalization for RA had a worse prognosis for all and many site-specific cancers compared with patients without RA, independent of age at diagnosis and tumour staging. Improvement of survival for cancer patients with RA may require a multidisciplinary approach to accommodate the comorbidity.
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19.
  • Liu, Xiangdong, et al. (författare)
  • Autoimmune diseases and subsequent urological cancers.
  • 2013
  • Ingår i: Journal of Urology. - : Ovid Technologies (Wolters Kluwer Health). - 1527-3792 .- 0022-5347. ; 189:6, s. 2262-2268
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To examine the subsequent risk and prognosis of urological cancers among individuals diagnosed with autoimmune(AI) diseases. MATERIALS AND METHODS: We analyzed systematically the risk and prognosis of prostate, kidney and bladder cancers among individuals diagnosed with any of 33 different AI diseases based on nation-wide Swedish database covering years 1964 through 2008. Standardized incidence ratios (SIRs) and hazard ratios (HRs) were calculated for subsequent urological cancers between 1964 and 2008 in individuals hospitalized for an AI disease. RESULTS: Increased SIRs for urological cancers were recorded after 26 AI diseases; increased HRs for cancer-specific survival were noted after 4 AI diseases and for overall survival after 18 AI diseases. The highest SIRs were seen for kidney cancer after polyarteritis nodosa (2.85), and polymyositis/dermatomyositis (2.68), and for bladder cancer after polymyositis/dermatomyositis (2.45). For prostate cancer, the highest risk (1.70) was observed after polyarteritis nodosa; the SIRs were lower in follow-up period 1990 to 2008 compared to the previous period. Individuals diagnosed with prostate and kidney cancers showed an improved cancer-specific prognosis, in contrast to the poorer overall prognosis for all 3 urological cancers. CONCLUSIONS: The risks for urological cancers were increased after all AI diseases and most significant changes after individual AI diseases were towards higher risks. The data on survival were reassuring that AI diseases influenced the prognosis of cancer-specific mortality marginally. However, the overall survival was decreased for the three cancers.
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20.
  • Liu, Xiangdong, et al. (författare)
  • Cancer risk and mortality in asthma patients: A Swedish national cohort study.
  • 2015
  • Ingår i: Acta Oncologica. - 1651-226X. ; 54:8, s. 1120-1127
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Previous studies found an increased risk of cancer in hospitalized asthma patients, but it is not known whether patients from primary health care show a similar risk pattern. In addition, it is unclear whether the diagnosis of asthma can influence the prognosis of subsequent cancer. Methods. Asthma patients were identified from Swedish inpatient, outpatient, and primary health care registers, and were linked to the Swedish Cancer Registry to identify subsequent diagnoses of cancer. Standardized incidence ratios (SIRs) were used to examine the risk of cancer in asthma patients compared with subjects without asthma. In addition, we used Cox proportional hazards regression to estimate hazard ratios (HRs) for mortality in patients with both asthma and cancer. Results. A total of 10 649 cancers were diagnosed in patients with previous asthma, with a SIR of 1.19 (95% CI 1.17-1.21). A total of 15 cancer sites showed an increased incidence, whereas two cancer sites showed a decreased risk. Non-allergic asthma showed the highest risk of cancer (SIR = 1.25, 95% CI 1.18-1.32), followed by unspecified asthma (SIR = 1.22, 95% CI 1.19-1.25), status asthmaticus (SIR = 1.19, 95% CI 1.02-1.39), and allergic asthma (SIR = 1.14, 95% CI 1.06-1.22). The risk of cancer was similarly increased in asthma patients diagnosed in primary health care and those diagnosed in hospitals. Cancer patients with previous asthma had increased mortality, with a HR of 1.55 (95% CI 1.50-1.60). HRs ranged from 1.09 to 1.94 for different sites/types of cancer. Conclusions. Patients with asthma, irrespective of whether they were treated in primary health care or hospitals, had an increased risk of cancer. In addition, cancer patients with previous asthma had a worse prognosis compared with those without asthma, suggesting that these patients may require a multidisciplinary approach to manage the comorbidity.
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21.
  • Liu, Xiangdong, et al. (författare)
  • Cancer risk in patients with hepatitis C virus infection : A population-based study in Sweden
  • 2017
  • Ingår i: Cancer Medicine. - : Wiley. - 2045-7634. ; 6:5, s. 1135-1140
  • Tidskriftsartikel (refereegranskat)abstract
    • Increased risks of certain cancers have been observed in patients with hepatitis C virus (HCV) infection. However, data on other cancer sites/types are lacking. We analyzed systematically the risk of developing 35 common cancers in patients with HCV infection using a nationwide Swedish database. Patients with HCV infection were identified from the Swedish Hospital Inpatient and Outpatient Register and Primary Health Care Database, and followed until the diagnosis of cancer. Standardized incidence ratios (SIRs) were calculated for subsequent 35 common cancer sites/types between 1990 and 2010 in patients with HCV infection in Sweden. Increased risks were recorded for six cancers. The highest SIR was seen for liver cancer (36.67; 95% CI: 33.20-40.40). The decreased risk was for prostate cancer (0.73; 95% CI: 0.59-0.90) and melanoma (0.50; 95% CI: 0.30-0.79). A significant sex-difference for cancer was observed only for liver cancer (40.72; 95% CI: 36.36-45.45 for men and 27.21; 95% CI: 21.90-33.41 for women). Also, increased SIRs were noted only for liver cancer during the entire period of follow-up. HCV infection was associated with an increased incidence of liver cancer and additionally five other types of cancer. Active surveillance of other cancers may be needed in order to be diagnosed at an earlier stage.
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22.
  • Liu, Xiangdong, et al. (författare)
  • Cancer risk in patients with type 2 diabetes mellitus and their relatives.
  • 2015
  • Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136. ; 137:4, s. 903-910
  • Tidskriftsartikel (refereegranskat)abstract
    • Epidemiological studies indicate that risks of certain cancers are increased in individuals hospitalized for type 2 diabetes mellitus (T2DM), which may not be representative of the entire population of T2DM patients as most of them are treated in primary health cares. To examine the subsequent cancer risk in individuals with T2DM from hospitals and primary health cares, and in their siblings and spouses, standardized incidence ratios (SIRs) were used to assess systematically risks of 35 cancer sites/types in individuals with T2DM using a nationwide Swedish database covering the period 1964 through 2010. Increased SIRs were recorded for 24 cancer sites/types in individuals with T2DM. The highest SIRs were for pancreatic cancer and liver cancer (2.98 and 2.43, respectively). A decreased SIR was noted for prostate cancer. Five cancers showed increased SIRs during the whole follow-up period: colon, liver, pancreatic, endometrial, and kidney cancers. T2DM patients in inpatient, outpatient and primary health care showed similar risk patterns. The overall SIRs for cancer in the siblings and spouses of individuals with T2DM were 0.97 and 1.01, respectively. The insulin users showed an overall increased risk of cancer. This study showed increased risks of 24 cancers in individuals with T2DM, but not in their siblings or spouses, suggesting that the profound metabolic disturbances of the underlying disease may explain the observed increases. Further studies examining the endogenous and exogenous factors underlying these associations are needed. This article is protected by copyright. All rights reserved.
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23.
  • Liu, Xiangdong, et al. (författare)
  • Mortality causes in cancer patients with type 2 diabetes mellitus.
  • 2012
  • Ingår i: European Journal of Cancer Prevention. - 1473-5709. ; 21, s. 300-306
  • Tidskriftsartikel (refereegranskat)abstract
    • Cancer patients diagnosed with type 2 diabetes mellitus (T2DM) are at an increased risk of death due to cancer. However, whether T2DM comorbidity increases other causes of death in cancer patients is the novel theme of this study. Patients with T2DM were identified from the nationwide Swedish Hospital Discharge Register and linked with patients with cancer recorded from the Swedish Cancer Registry. Hazard ratios (HRs) were calculated for death due to all causes among cancer patients with and without T2DM; both underlying and multiple causes of death were examined using the Cox regression model. A total of 13 325 cancer patients were identified with comorbidity of T2DM. The total number of deaths of cancer patients was 276 021. Of these, 5900 occurred after T2DM diagnosis. For underlying causes of death, except for T2DM, the highest cause-specific HRs were found for complications of bacterial disease (HR, 3.93; 95% CI, 3.04-5.09), urinary system disease (HR, 3.39; 95% CI, 2.78-4.12), and myocardial infarction (HR, 2.93; 95% CI, 2.75-3.12). When risk of death was examined for both underlying and multiple causes of death, the highest HRs were found for hypertensive disease (HR, 3.42; 95% CI, 3.15-3.72), urinary system disease (HR, 3.39; 95% CI, 3.17-3.63), and arterial disease (HR, 3.26; 95% CI, 3.08-3.46). The diagnosis of T2DM in cancer patients is associated with an increased risk of death due to various causes, including myocardial infarction, other bacterial disease, urinary system disease, hypertensive disease, arterial disease, and so on, which may be related to both cancer and treatment. Clinicians that treat cancer patients with T2DM should pay more attention to comorbidities.
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24.
  • Liu, Xiangdong, et al. (författare)
  • The impact of type 2 diabetes mellitus on cancer-specific survival: A follow-up study in sweden.
  • 2012
  • Ingår i: Cancer. - : Wiley. - 1097-0142 .- 0008-543X. ; 118:5, s. 1353-1361
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Earlier studies have suggested that type 2 diabetes mellitus (T2DM) alters the risk of developing a variety of cancers, but little has been known about the impact of T2DM on cancer prognosis. On the basis of nationwide population-based Swedish registries, the authors of this report compared the cause-specific survival among cancer patients with and without T2DM. METHODS: Patients with T2DM were identified from the nationwide Swedish Hospital Discharge Register, and cancers were recorded from the Swedish Cancer Registry. Hazard ratios (HRs) were calculated using Cox regression models to compare variations in cause-specific survival between cancer patients with and without T2DM. RESULTS: Of the 1016,105 cancer patients, 16,123 had been hospitalized with T2DM before their diagnosis of cancer. The mortality rate was significantly higher among cancer patients with T2DM than among those without T2DM (cause-specific HR, 1.38; 95% confidence interval, 1.35-1.41). There were no differences in TNM stage distribution among cancer patients with or without T2DM for the main cancers, with an exception of tumor and metastatic classifications for breast cancer and prostate cancer, respectively. CONCLUSIONS: The current results indicated that patients with T2DM who are diagnosed with a subsequent cancer are at an increased risk for cause-specific mortality compared with patients who have cancer without T2DM.
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25.
  • Watts, Anna L., et al. (författare)
  • Dense matter with eXTP
  • 2019
  • Ingår i: Science China Physics, Mechanics & Astronomy. - : Science Press. - 1674-7348 .- 1869-1927. ; 62:2
  • Forskningsöversikt (refereegranskat)abstract
    • In this White Paper we present the potential of the Enhanced X-ray Timing and Polarimetry (eXTP) mission for determining the nature of dense matter; neutron star cores host an extreme density regime which cannot be replicated in a terrestrial laboratory. The tightest statistical constraints on the dense matter equation of state will come from pulse profile modelling of accretion-powered pulsars, burst oscillation sources, and rotation-powered pulsars. Additional constraints will derive from spin measurements, burst spectra, and properties of the accretion flows in the vicinity of the neutron star. Under development by an international Consortium led by the Institute of High Energy Physics of the Chinese Academy of Sciences, the eXTP mission is expected to be launched in the mid 2020s.
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