Department of Dermatology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
Br J Dermatol. 2012 Nov;167(5):1067-75. doi: 10.1111/j.1365-2133.2012.11161.x. Epub 2012 Oct 5.
The risk of cancer in patients with autoimmune diseases has been investigated in several studies. Ro/SS-A antibodies are frequent and specific autoantibodies among patients with various autoimmune diseases.
To assess the risk of cancer in individuals with positive Ro/SS-A antibodies and to analyse their clinical and laboratory characteristics.
Consecutive patients (n = 303) with Ro/SS-A antibody positivity were collected during 11 years in our outpatient clinic for autoimmune diseases and were retrospectively analysed. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for all cancers were calculated. In addition, we identified further clinical and laboratory characteristics of Ro/SS-A antibody-positive patients indicating the development or existence of a malignancy.
Fifty (16·5%) patients were diagnosed with malignancies. Ro/SS-A antibody was strongly associated with malignant diseases (SIR 2·6, 95% CI 1·9-6·1), particularly melanoma (SIR 33·3, 95% CI 5·2-188·6), T-cell lymphoma (SIR 16·7, 95% CI 2·9-128·9), non-Hodgkin lymphoma (SIR 10·6, 95% CI 1·5-78·9) and breast carcinoma (SIR 4·98, 95% CI 1·3-28·3). Logistic regression modelling revealed that Ro/SS-A antibody-positive patients aged 55 years or older, presenting with fever, anaemia and cutaneous lupus erythematosus, have a greater probability of developing cancer and are considered high-risk patients, as compared with Ro/SS-A antibody-positive patients with none of the mentioned clinical criteria.
In our cohort of Ro/SS-A antibody-positive patients, an overall increased risk of malignancy was noticed. Regular screening tests including imaging and laboratory values are justified in Ro/SS-A antibody-positive patients who exhibit the mentioned clinical criteria.
自身免疫性疾病患者的癌症风险已在多项研究中进行了探讨。Ro/SS-A 抗体是各种自身免疫性疾病患者中常见且具有特异性的自身抗体。
评估 Ro/SS-A 抗体阳性个体的癌症风险，并分析其临床和实验室特征。
在我们的自身免疫性疾病门诊 11 年期间，连续收集了 303 例 Ro/SS-A 抗体阳性的患者，并进行回顾性分析。计算了所有癌症的标准化发病比（SIR）及其 95%置信区间（CI）。此外，我们还确定了 Ro/SS-A 抗体阳性患者的其他临床和实验室特征，这些特征表明恶性肿瘤的发生或存在。
50 例（16.5%）患者被诊断患有恶性肿瘤。Ro/SS-A 抗体与恶性疾病密切相关（SIR 2.6，95%CI 1.9-6.1），特别是黑色素瘤（SIR 33.3，95%CI 5.2-188.6）、T 细胞淋巴瘤（SIR 16.7，95%CI 2.9-128.9）、非霍奇金淋巴瘤（SIR 10.6，95%CI 1.5-78.9）和乳腺癌（SIR 4.98，95%CI 1.3-28.3）。Logistic 回归模型显示，55 岁或以上 Ro/SS-A 抗体阳性、伴有发热、贫血和皮肤红斑狼疮的患者发生癌症的可能性更大，被认为是高危患者，与无上述临床标准的 Ro/SS-A 抗体阳性患者相比。
在我们的 Ro/SS-A 抗体阳性患者队列中，注意到总体恶性肿瘤风险增加。在具有上述临床标准的 Ro/SS-A 抗体阳性患者中，应进行常规筛查试验，包括影像学和实验室检查。
