Baecklund E, Backlin C, Rönnelid J, Toes R, Huizinga Twj, Åhlin E, Askling J, Hochberg F H, Klareskog L, Kay J, Smedby K E
a Department of Medical Sciences, Unit of Rheumatology , Uppsala University , Uppsala , Sweden.
b Department of Immunology, Genetics and Pathology , Uppsala University , Uppsala , Sweden.
Scand J Rheumatol. 2018 Jul;47(4):270-275. doi: 10.1080/03009742.2017.1376108. Epub 2018 Jan 16.
Patients with rheumatoid arthritis (RA) are at increased risk of lymphoma. There is no biomarker to indicate future lymphoma risk in RA and it is not known whether factors associated with an increased risk of RA also confer an increased risk of lymphoma. We investigated whether anti-cyclic citrullinated peptide (CCP) antibodies, other autoantibodies, and smoking, are associated with lymphoma development in RA.
From two population-based case-control studies, the Scandinavian Lymphoma Etiology (SCALE) study and the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) I study, we identified lymphoma cases with a validated RA diagnosis (n = 50), to whom we matched study participants with RA but no lymphoma (n = 261), lymphoma but no RA (n = 257), and neither RA nor lymphoma (n = 233). Lymphomas were classified according to the WHO classification. Blood samples were analysed for immunoglobulin G (IgG), IgM, and IgA isotypes and IgG subclasses of anti-CCP antibodies and for 15 antinuclear antibody (ANA)-associated specific autoantibodies. Relative risks were estimated as crude and adjusted odds ratios (adjOR) with 95% confidence intervals (CIs) using logistic regression.
We found no association between anti-CCP IgG ≥ 25 units/mL (adjOR 1.4, 95% CI 0.7-2.7), anti-CCP IgG ≥ 500 units/mL (adjOR 1.4, 95% CI 0.7-3.0), anti-CCP Ig of other isotypes, other autoantibodies (adjOR any vs none 0.6, 95% CI 0.3-1.2), or cigarette smoking (adjOR ever vs never 1.1, 95% CI 0.5-2.2) and lymphoma risk among patients with RA.
In this study, neither anti-CCP antibodies (IgG, IgG, IgM, or IgA), nor other common autoantibodies, nor smoking predicted lymphoma risk in RA.
类风湿关节炎（RA）患者患淋巴瘤的风险增加。目前尚无生物标志物可指示RA患者未来患淋巴瘤的风险，且尚不清楚与RA风险增加相关的因素是否也会增加淋巴瘤风险。我们调查了抗环瓜氨酸肽（CCP）抗体、其他自身抗体和吸烟是否与RA患者淋巴瘤的发生有关。
从两项基于人群的病例对照研究，即斯堪的纳维亚淋巴瘤病因（SCALE）研究和类风湿关节炎流行病学调查（EIRA）I研究中，我们确定了经证实患有RA的淋巴瘤病例（n = 50），并为其匹配了患有RA但无淋巴瘤的研究参与者（n = 261）、患有淋巴瘤但无RA的参与者（n = 257）以及既无RA也无淋巴瘤的参与者（n = 233）。淋巴瘤根据世界卫生组织分类进行分类。对血液样本进行免疫球蛋白G（IgG）、IgM和IgA同种型以及抗CCP抗体的IgG亚类和15种抗核抗体（ANA）相关特异性自身抗体的分析。使用逻辑回归将相对风险估计为粗比值比和调整比值比（adjOR）以及95%置信区间（CI）。
我们发现抗CCP IgG≥25单位/毫升（adjOR 1.4，95%CI 0.7 - 2.7）、抗CCP IgG≥500单位/毫升（adjOR 1.4，95%CI 0.7 - 3.0）、其他同种型的抗CCP Ig、其他自身抗体（adjOR任何与无相比0.6，95%CI 0.3 - 1.2）或吸烟（adjOR曾经吸烟与从不吸烟相比1.1，95%CI 0.5 - 2.2）与RA患者的淋巴瘤风险之间均无关联。
在本研究中，抗CCP抗体（IgG、IgG、IgM或IgA）、其他常见自身抗体以及吸烟均不能预测RA患者的淋巴瘤风险。
