Singh Abha G, Crowson Cynthia S, Singh Siddharth, Davis Mark Denis P, Maradit-Kremers Hilal, Matteson Eric L, Chowdhary Vaidehi R
Division of Rheumatology, Mayo Clinic, Rochester, MN.
Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, CA.
Rheumatology (Oxford). 2016 Nov;55(11):2009-2013. doi: 10.1093/rheumatology/kew291. Epub 2016 Aug 12.
Immune dysregulation associated with chronic autoimmune diseases, such as SLE, has been associated with increased cancer risk. It is unclear whether isolated cutaneous lupus erythematosus (CLE) modifies cancer risk. We estimated the cumulative incidence of cancer in a population-based CLE cohort and compared the risk with a matched non-CLE cohort.
All incident cases of CLE in Olmsted County, MN, USA between 1965 and 2005 were identified and followed to December 2013. Estimates for the cumulative incidence of any cancer and skin cancer in patients with CLE were derived and compared with an age-, sex- and calendar-year-matched non-CLE cohort using Cox models.
There were a total of 155 patients with CLE [age at diagnosis, 48 (sd 16) years; 65% females; BMI, 26.3 (sd 7.1) kg/m; 40% smokers, 9% with diabetes]. During a median follow-up of 14.6 years, we observed 35 cases of incident cancer (including 10 cases of skin cancer). The cumulative 1-, 5- and 10-year incidence of any cancer after diagnosis of CLE was 1.4, 7.5 and 11.6%, respectively. Compared with matched non-CLE controls, the overall risk of malignancies was not increased in patients with CLE (smoking-adjusted hazard ratio = 1.29; 95% CI: 0.78, 2.13; P = 0.31). There was also no significant increase in risk of any skin cancer in patients with CLE (hazard ratio = 2.51; 95% CI: 0.91, 6.96; P = 0.16).
CLE is not associated with an increased risk of any cancers, including skin cancers, compared with the general population. However, the number of events was small, limiting the power of the study.
与慢性自身免疫性疾病（如系统性红斑狼疮）相关的免疫失调与癌症风险增加有关。目前尚不清楚孤立性皮肤红斑狼疮（CLE）是否会改变癌症风险。我们估计了一个基于人群的CLE队列中的癌症累积发病率，并将其风险与匹配的非CLE队列进行比较。
确定了1965年至2005年期间美国明尼苏达州奥尔姆斯特德县所有CLE的发病病例，并随访至2013年12月。得出CLE患者中任何癌症和皮肤癌的累积发病率估计值，并使用Cox模型与年龄、性别和日历年份匹配的非CLE队列进行比较。
共有155例CLE患者[诊断时年龄为48（标准差16）岁；65%为女性；体重指数为26.3（标准差7.1）kg/m²；40%为吸烟者，9%患有糖尿病]。在中位随访14.6年期间，我们观察到35例新发癌症病例（包括10例皮肤癌）。CLE诊断后任何癌症的1年、5年和10年累积发病率分别为1.4%、7.5%和11.6%。与匹配的非CLE对照组相比，CLE患者的总体恶性肿瘤风险没有增加（吸烟调整后的风险比=1.29；95%置信区间：0.78，2.13；P=0.31）。CLE患者中任何皮肤癌的风险也没有显著增加（风险比=2.51；95%置信区间：0.91，6.96；P=0.16）。
与普通人群相比，CLE与任何癌症（包括皮肤癌）风险增加无关。然而，事件数量较少，限制了研究的效力。
