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癌症与自身免疫性疾病。

Cancer and autoimmune diseases.

机构信息

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

Autoimmun Rev. 2017 Oct;16(10):1049-1057. doi: 10.1016/j.autrev.2017.07.022. Epub 2017 Aug 1.

Abstract

PURPOSE OF REVIEW

The association between autoimmunity and cancer is well established. Cancer has been implicated in some autoimmune disorders (AID), such as scleroderma and myositis. On the other hand, many autoimmune disorders and immunosuppressive therapy, have been linked to an increased risk for cancer. We reviewed the accumulating data on the association between autoimmunity and cancer during the past three years, with an emphasis on large cohorts, as well as concept changing discoveries in the association of cancer and auto-immunity.

RECENT FINDINGS

Recent published data from large registries and databases have changed our perspective on the association of AID and cancer, as well as the presumed association between anti-tumor necrosis factor (anti -TNF) therapy and certain malignancies, suggesting a small to no increase in almost all types of cancers. Similarly, the increased risk of malignancies in some AID, such as Sjogren's syndrome (SS) and lupus, may be different from previous estimations. New associations with malignancies were discovered, such as IgG4 related disease, Behcet's and sarcoidosis, which were not clearly associated with cancer in the past. These newly described associations may have clinical implications and contribute to our understanding of both autoimmunity and cancer. Similarly, we reviewed studies of autoimmunity secondary to malignancy, and the concomitant appearance of cancer with autoimmune disease, such as the discovery of a specific mutation in scleroderma (SS) patients that developed cancer, which establishes the association between these disorders and sheds light on the pathology behind this association.

摘要

目的综述

自身免疫与癌症之间的关联已得到充分证实。癌症与一些自身免疫性疾病(AID)有关,如硬皮病和肌炎。另一方面,许多自身免疫性疾病和免疫抑制治疗与癌症风险增加有关。我们回顾了过去三年中关于自身免疫与癌症之间关联的累积数据,重点关注大型队列研究,以及癌症与自身免疫关联方面的概念性发现。

最新发现

来自大型注册中心和数据库的最新发表数据改变了我们对 AID 和癌症关联的看法,以及对肿瘤坏死因子(anti -TNF)治疗与某些恶性肿瘤之间假定关联的看法,表明几乎所有类型的癌症风险都略有增加。同样,某些自身免疫性疾病(如干燥综合征(SS)和狼疮)中恶性肿瘤的风险增加可能与以前的估计不同。发现了与恶性肿瘤的新关联,如 IgG4 相关疾病、贝赫切特病和结节病,这些疾病过去与癌症没有明确关联。这些新描述的关联可能具有临床意义,并有助于我们理解自身免疫和癌症。同样,我们综述了继发于恶性肿瘤的自身免疫以及自身免疫性疾病与癌症同时出现的研究,例如在发生癌症的硬皮病(SS)患者中发现特定突变,这确立了这些疾病之间的关联,并揭示了这种关联背后的病理学。

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