Department of Family Medicine, The Catholic University of Korea Incheon St. Mary's Hospital, Incheon, South Korea.
Yonsei University Graduate School of Medicine, Seoul, South Korea.
Clin Rheumatol. 2019 Nov;38(11):3109-3116. doi: 10.1007/s10067-019-04660-9. Epub 2019 Jul 3.
Accumulating evidences suggest that the incidence of several cancers is higher in systemic lupus erythematosus (SLE) than in general population. However, the finding on pancreatic cancer risk is inconsistent. This meta-analysis aimed to determine whether SLE patients are at risk for pancreatic cancer.
We searched PubMed, Embase, and the Cochrane database to screen the studies meeting our criteria. The hazard ratios (HRs) and its 95% confidence interval (CIs) were calculated from a meta-analysis.
Eleven cohort studies were included in the final analysis. Overall, patients with SLE had an increased risk of pancreatic cancer (HR = 1.42, CI = 1.32-1.53). In subgroup analysis, hospital-based (HR = 1.43, CI = 1.32-1.54), retrospective (HR = 1.42, CI = 1.32-1.54), over 10 years followed (HR = 1.44, CI = 1.33-1.55), and low-quality studies (HR = 1.42, CI = 1.31-1.53) remained robust. Significant publication bias was not observed among the studies (p = 0.533).
The synthesized evidence from our meta-analysis demonstrated that SLE was associated with increased risk for pancreatic cancer. A well-designed, long-period followed study is needed to confirm this association. Key Points • Cancer incidence in SLE patients is increasing, but the data concerning pancreatic cancer remains inconclusive. • Our meta-analysis indicated that the risk of pancreatic cancer was significantly increased in SLE patients. • A well-designed, long-period followed study is needed to confirm the association.
越来越多的证据表明，系统性红斑狼疮（SLE）患者的几种癌症发病率高于普通人群。然而，关于胰腺癌风险的研究结果并不一致。本荟萃分析旨在确定 SLE 患者是否存在胰腺癌风险。
我们检索了 PubMed、Embase 和 Cochrane 数据库，筛选出符合我们标准的研究。使用荟萃分析计算了风险比（HR）及其 95%置信区间（CI）。
最终有 11 项队列研究纳入荟萃分析。总体而言，SLE 患者发生胰腺癌的风险增加（HR=1.42，95%CI=1.32-1.53）。亚组分析显示，基于医院的研究（HR=1.43，95%CI=1.32-1.54）、回顾性研究（HR=1.42，95%CI=1.32-1.54）、随访时间超过 10 年的研究（HR=1.44，95%CI=1.33-1.55）和低质量研究（HR=1.42，95%CI=1.31-1.53）结果仍具稳健性。未观察到研究间存在显著的发表偏倚（p=0.533）。
我们的荟萃分析综合证据表明，SLE 与胰腺癌风险增加相关。需要设计良好、随访时间长的研究来进一步证实这种关联。
癌症在 SLE 患者中的发病率在增加，但关于胰腺癌的数据仍存在争议。
我们的荟萃分析表明，SLE 患者发生胰腺癌的风险显著增加。
需要设计良好、随访时间长的研究来进一步证实这种关联。
