系统性红斑狼疮患者癌症发病率增加：一项随访超过25年的芬兰队列研究

Increased incidence of cancer in systemic lupus erythematosus: a Finnish cohort study with more than 25 years of follow-up.

作者信息

Tallbacka K R, Pettersson T, Pukkala E

机构信息

a Department of Internal Medicine, Faculty of Medicine , University of Helsinki , Helsinki , Finland.

b Department of Internal Medicine and Rehabilitation , Helsinki University Hospital , Helsinki , Finland.

出版信息

Scand J Rheumatol. 2018 Nov;47(6):461-464. doi: 10.1080/03009742.2017.1384054. Epub 2018 Jan 10.

DOI:10.1080/03009742.2017.1384054

PMID:29318934

Abstract

OBJECTIVE

The aim of this study was to assess the cancer risk in a cohort of Finnish patients with systemic lupus erythematosus (SLE) when followed over the long term.

METHOD

The cohort consisted of 182 female and 23 male SLE patients treated at the Helsinki University Central Hospital from 1967 to 1987. The cohort was linked to the Finnish Cancer Registry and followed for cancer incidence from 1967 to 2013. Standardized incidence ratios (SIRs) were calculated by dividing the number of observed cases by the number of expected cases for different types of cancer.

RESULTS

The mean duration of follow-up was 25.7 years. Forty-five patients out of 205 were diagnosed with cancer, with an increased risk of overall malignancy [SIR 1.90, 95% confidence interval (CI) 1.39-2.54, p < 0.001]. The incidences of soft-tissue sarcoma (SIR 12.1, 95% CI 1.47-43.7, p < 0.05), non-Hodgkin's lymphoma (SIR 12.1, 95% CI 5.82-22.3, p < 0.001), and kidney cancer (SIR 7.79, 95% CI 2.53-18.2, p < 0.01) were significantly elevated.

CONCLUSION

This long-term study confirms that patients with SLE have an increased risk of cancer, particularly non-Hodgkin's lymphoma and kidney cancer.

摘要

目的

本研究旨在评估芬兰系统性红斑狼疮（SLE）患者长期随访中的癌症风险。

方法

该队列由1967年至1987年在赫尔辛基大学中心医院接受治疗的182名女性和23名男性SLE患者组成。该队列与芬兰癌症登记处建立联系，并随访1967年至2013年的癌症发病率。通过将不同类型癌症的观察病例数除以预期病例数来计算标准化发病率（SIR）。

结果

平均随访时间为25.7年。205名患者中有45名被诊断患有癌症，总体恶性肿瘤风险增加[SIR 1.90，95%置信区间（CI）1.39 - 2.54，p < 0.001]。软组织肉瘤（SIR 12.1，95% CI 1.47 - 43.7，p < 0.05）、非霍奇金淋巴瘤（SIR 12.1，95% CI 5.82 - 22.3，p < 0.001）和肾癌（SIR 7.79，95% CI 2.53 - 18.2，p < 0.01）的发病率显著升高。