Division of Immunology, Department of Pediatrics, Kuo General Hospital, National Cheng Kung University Hospital, Tainan, Taiwan.
Department of Statistics, National Cheng Kung University Hospital, Tainan, Taiwan.
Rheumatology (Oxford). 2019 Jul 1;58(7):1245-1249. doi: 10.1093/rheumatology/kez011.
We conducted this nationwide population-based study in Taiwan to investigate whether there is a bidirectional relationship between SLE and non-Hodgkin's lymphoma (NHL).
Using the National Health Insurance Research Database of Taiwan, we identified 16 417 patients with new-onset SLE without previous cancer and 25 069 patients with new-onset NHL without previous SLE as two non-overlapping cohorts from 1998-2012, and followed them until 2013. Standardized incidence ratio (SIR) for NHL in the patients with SLE and SIR for SLE in the patients with NHL were compared with the general population.
Among the 16 417 patients with SLE, 512 developed cancers, including 34 with NHL. The highest SIR was that for NHL (SIR 4.2, 95% CI 2.9, 5.9) in site-specific cancer risk analysis. Among the 25 069 patients with NHL, 14 developed SLE, and the SIR was also increased (SIR 2.0, 95% CI 1.1, 3.4). The SIRs of the patients with SLE to develop NHL and the patients with NHL to develop SLE were both highest within the first year after the diagnosis of each disease.
This nationwide population-based study is the first study to report a bidirectional relationship between SLE and NHL. This finding may suggest being alert for the patients with SLE or NHL who have early sings of the other disease in clinical care.
我们在台湾进行了这项全国性的基于人群的研究，以调查系统性红斑狼疮（SLE）和非霍奇金淋巴瘤（NHL）之间是否存在双向关系。
我们使用台湾全民健康保险研究数据库，从 1998 年至 2012 年确定了 16417 例无先前癌症的新诊断 SLE 患者和 25069 例无先前 SLE 的新诊断 NHL 患者作为两个不重叠的队列，并对他们进行随访至 2013 年。SLE 患者 NHL 的标准化发病比（SIR）和 NHL 患者 SLE 的 SIR 与一般人群进行比较。
在 16417 例 SLE 患者中，有 512 例发生癌症，包括 34 例 NHL。在肿瘤部位特异性风险分析中，NHL 的 SIR 最高（SIR 4.2，95%CI 2.9，5.9）。在 25069 例 NHL 患者中，有 14 例发生 SLE，SIR 也增加（SIR 2.0，95%CI 1.1，3.4）。SLE 患者发生 NHL 和 NHL 患者发生 SLE 的 SIR 在每种疾病诊断后的第一年最高。
这项全国性的基于人群的研究是第一项报告 SLE 和 NHL 之间存在双向关系的研究。这一发现可能表明，在临床护理中，对于那些有早期迹象的 SLE 或 NHL 患者，需要保持警惕。
