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风湿性疾病中的合并症:一项回顾性基于医院的研究。

Malignancy as a comorbidity in rheumatic diseases: a retrospective hospital-based study.

机构信息

Division of Rheumatology, Guang An Men Hospital, China Academy of Chinese Medical Science, Beijing, 100053, China.

Guiyang University of Chinese Medicine, Guiyang, 550025, China.

出版信息

Clin Rheumatol. 2018 Jan;37(1):81-85. doi: 10.1007/s10067-017-3676-8. Epub 2017 May 16.

Abstract

Patients with Rheumatic diseases (RDs) are at an increased risk of malignancies compared with the general population. The aim of this study was to examine the relative frequency of several cancers in a single homogeneous cohort of patients with different RDs. Patients diagnosed with rheumatoid arthritis (RA), Ankylosing spondylitis (AS), Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), dermatomyositis (DM), or polymyositis were included. Out of 3982 adult residents admitted to the division of rheumatology, 61 malignancies were observed. The 2009 National Central Cancer Registry (NCCR) of China served as the reference for calculating standardized ratio (SR). The malignancy frequency had no difference between RDs with malignancy and the general population. Patients with SS and DM/PM showed an increased risk of non-Hodgkin's lymphoma (SR for SS patients = 9.709, 95% confidence interval (CI) = 4.602 to 17.916; SR for DM/PM = 35.714, 95% CI = 25.001 to 49.527). Patients with DM/PM and SSc showed an increased risk of lung cancer (SR for DM/PM = 10.638, 95% CI = 5.245 to 19.131; SR for SSc patients = 7.752, 95% CI = 3.295 to 15.309). Patients with SS and DM/PM showed an increased risk of ovary cancer (SR for SS patients = 8.177, 95% CI = 3.566 to 15.888; SR for DM/PM = 32.258, 95% CI = 22.126 to 45.490). Patients with SLE showed an increased risk of cervix cancer (SR for AS patients = 6.897, 95% CI = 2.748 to 14.144). Patients with AS showed an increased risk of pancreas cancer (SR for AS patients = 7.576, 95% CI = 2.181 to 15. 071). Different RDs have an increased risk of particular cancers. Among hematologic cancers, the risk of non-Hodgkin's lymphoma was higher than general population. Among solid tumors, the risk of cancers of the lung, ovary, cervix, and pancreas was higher than general population.

摘要

患有风湿性疾病 (RDs) 的患者与普通人群相比,恶性肿瘤的风险增加。本研究的目的是在单一同质的 RDs 患者队列中检查几种癌症的相对频率。纳入了类风湿关节炎 (RA)、强直性脊柱炎 (AS)、干燥综合征 (SS)、系统性红斑狼疮 (SLE)、系统性硬皮病 (SSc)、皮肌炎 (DM) 或多肌炎的患者。在风湿科收治的 3982 名成年居民中,观察到 61 例恶性肿瘤。2009 年中国国家癌症中心登记处 (NCCR) 用于计算标准化比值 (SR)。恶性肿瘤的发生率在有恶性肿瘤和普通人群的 RDs 之间没有差异。SS 和 DM/PM 患者患非霍奇金淋巴瘤的风险增加(SS 患者的 SR = 9.709,95%置信区间 [CI] = 4.602 至 17.916;DM/PM 的 SR = 35.714,95%CI = 25.001 至 49.527)。DM/PM 和 SSc 患者患肺癌的风险增加(DM/PM 的 SR = 10.638,95%CI = 5.245 至 19.131;SSc 患者的 SR = 7.752,95%CI = 3.295 至 15.309)。SS 和 DM/PM 患者患卵巢癌的风险增加(SS 患者的 SR = 8.177,95%CI = 3.566 至 15.888;DM/PM 的 SR = 32.258,95%CI = 22.126 至 45.490)。SLE 患者患宫颈癌的风险增加(AS 患者的 SR = 6.897,95%CI = 2.748 至 14.144)。AS 患者患胰腺癌的风险增加(AS 患者的 SR = 7.576,95%CI = 2.181 至 15.071)。不同的 RDs 有特定癌症的风险增加。在血液系统恶性肿瘤中,非霍奇金淋巴瘤的风险高于普通人群。在实体肿瘤中,肺癌、卵巢癌、宫颈癌和胰腺癌的风险高于普通人群。

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