Division of Rheumatology, McGill University Health Centre, Montreal, QC, Canada.
Br J Cancer. 2011 Apr 26;104(9):1478-81. doi: 10.1038/bjc.2011.115. Epub 2011 Apr 12.
An increased lymphoma risk is well documented in systemic lupus (SLE). Less attention has been focused on women's cancers, even though SLE affects mostly females. Our objective was to estimate the risk of breast, ovarian, and endometrial cancers in SLE, relative to the general population.
Data were included from five recent studies of large SLE cohorts. The number of cancers observed was determined for each cancer type. The expected number of malignancies was ascertained from general population data. The parameter of interest was the standardised incidence ratio (SIR), the ratio of observed to expected malignancies.
The five studies included 47,325 SLE patients (42,171 females) observed for 282,553 patient years. There were 376 breast cancers, 66 endometrial cancers, and 44 ovarian cancers. The total number of cancers observed was less than that expected, with SIRs of 0.76 (95% CI: 0.69, 0.85) for breast cancer, 0.71 (95% CI: 0.55, 0.91) for endometrial cancer, and 0.66 (95% CI: 0.49, 0.90) for ovarian cancer.
Data strongly support a decreased risk of breast, ovarian, and endometrial cancers in SLE. This may be due to inherent differences in women in SLE (vs the general population) regarding endogenous oestrogen, other medications, and/or genetic make-up.
系统性红斑狼疮（SLE）患者的淋巴瘤风险增加已得到充分证实。然而，人们对女性癌症的关注相对较少，尽管 SLE 主要影响女性。我们的目的是评估 SLE 患者患乳腺癌、卵巢癌和子宫内膜癌的风险，与普通人群相比。
我们纳入了五项最近的大型 SLE 队列研究的数据。确定了每种癌症类型的观察到的癌症数量。通过一般人群数据确定了预期的恶性肿瘤数量。关注的参数是标准化发病比（SIR），即观察到的与预期的恶性肿瘤的比值。
这五项研究共纳入了 47325 名 SLE 患者（42171 名女性），观察了 282553 人年。共有 376 例乳腺癌、66 例子宫内膜癌和 44 例卵巢癌。观察到的癌症总数少于预期，乳腺癌、子宫内膜癌和卵巢癌的 SIR 分别为 0.76（95%CI：0.69，0.85）、0.71（95%CI：0.55，0.91）和 0.66（95%CI：0.49，0.90）。
数据强烈支持 SLE 患者患乳腺癌、卵巢癌和子宫内膜癌的风险降低。这可能是由于 SLE 患者（与普通人群相比）内在的雌激素、其他药物和/或遗传构成的差异所致。
