Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, Heidelberg, D-69120, Germany.
J Hematol Oncol. 2012 Oct 2;5:59. doi: 10.1186/1756-8722-5-59.
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.
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.
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.
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.
许多自身免疫性疾病（AIDs）患者罹患癌症的风险增加，这可能取决于免疫系统的潜在失调或治疗。我们系统地分析了 33 种不同 AIDs 患者的骨髓瘤风险和生存情况。
从瑞典住院登记处检索 AIDs 患者的数据，并与癌症登记处的骨髓瘤诊断结果相关联。计算了 1964 年至 2008 年间随后发生的骨髓瘤的标准化发病比（SIR）和风险比（HR）。
在所分析的 33 种 AIDs 患者中，诊断出 457 例骨髓瘤病例。骨髓瘤的总体 SIR 为 1.12，总体 HR 为 0.92，无显著性差异。强直性脊柱炎（2.02）和系统性硬化症（2.63）后骨髓瘤的 SIR 显著升高。仅风湿热后骨髓瘤的 HR（5.27）显著升高。60 岁以下骨髓瘤的 SIR 为 1.45；仅在 1964-1990 年期间（1.31），而不是以后（1.04）骨髓瘤的 SIR 增加。仅在强直性脊柱炎后，1991-2008 年期间骨髓瘤的 SIR 增加（2.09）；多发性肌炎/皮肌炎（6.44）和风湿热（4.43）后骨髓瘤的 HR 增加，但这些 AIDs 后仅有 3 例骨髓瘤死亡。
目前的数据显示，两种 AIDs（强直性脊柱炎和系统性硬化症）后骨髓瘤 SIR 增加，风湿热后 HR 增加。在 1991 年至 2008 年的后续随访期间，任何 AID 后总体骨髓瘤风险不再增加。
