From the Hospital for Rheumatic Diseases, Haugesund; Department of Clinical Science, University of Bergen, Bergen; Bergen Group of Epidemiology and Biomarkers in Rheumatic Disease (BEaBIRD), Department of Rheumatology, and Centre for Clinical Research, Haukeland University Hospital, Bergen; Martina Hansens Hospital, Bærum, Norway.
L.K. Brekke, MD, Hospital for Rheumatic Diseases, and Department of Clinical Science, University of Bergen; B.T. Fevang, MD, PhD, Department of Clinical Science, University of Bergen, and BEaBIRD, Department of Rheumatology, Haukeland University Hospital; A.P. Diamantopoulos, MD, PhD, MPH, Martina Hansens Hospital; J. Assmus, PhD, Centre for Clinical Research, Haukeland University Hospital; E. Esperø, MD, Hospital for Rheumatic Diseases; C. Gram Gjesdal, MD, PhD, Department of Clinical Science, University of Bergen, and BEaBIRD, Department of Rheumatology, Haukeland University Hospital.
J Rheumatol. 2020 May 1;47(5):722-729. doi: 10.3899/jrheum.190147. Epub 2019 Jul 15.
To determine the risk of cancer in a large Norwegian cohort of patients with giant cell arteritis (GCA).
This is a hospital-based, retrospective, observational cohort study including patients diagnosed with GCA in the Bergen Health Area during 1972-2012. Patients were identified through computerized hospital records using the International Classification of Diseases coding system. Medical records were reviewed. Each patient was randomly assigned population controls matched on age, sex, and geography from the Central Population Registry of Norway. Data on the occurrence of cancer were obtained from the Cancer Registry of Norway. The cumulative risk of malignancy was estimated using Kaplan-Meier methods and potential differences were analyzed using the Gehan-Breslow and log-rank tests.
We identified 881 cases with a clinical diagnosis of GCA, of which 792 fulfilled the American College of Rheumatology (ACR) 1990 classification criteria and 528 were biopsy-verified. Cases with no registered cancer prior to GCA diagnosis were included in a time-to-event analysis, with first cancer as the event (n = 767 with clinical GCA diagnosis, 686 fulfilling ACR criteria for GCA, 463 biopsy-verified). These cases were matched with previously cancer-free population controls (n = 1437, 1284, 895, respectively). We found no significant difference in the risk of malignancy after time of diagnosis/matching for GCA patients compared to population controls (p > 0.05).
In this study of a large and well-characterized cohort of patients with GCA, there was no difference in the risk of malignancy in patients with GCA compared to matched population controls.
在一个大型挪威巨细胞动脉炎(GCA)患者队列中确定癌症风险。
这是一项基于医院的回顾性观察队列研究,纳入了 1972 年至 2012 年期间在卑尔根卫生区诊断为 GCA 的患者。通过使用国际疾病分类系统的计算机化医院记录来识别患者。审查病历。每位患者均从挪威中央人口登记处随机分配与年龄、性别和地理匹配的人群对照。从挪威癌症登记处获得癌症发生的数据。使用 Kaplan-Meier 方法估计恶性肿瘤的累积风险,并使用 Gehan-Breslow 和对数秩检验分析潜在差异。
我们确定了 881 例临床诊断为 GCA 的病例,其中 792 例符合美国风湿病学会(ACR)1990 年分类标准,528 例经活检证实。在 GCA 诊断之前未登记癌症的病例被纳入时间事件分析,以首次癌症为事件(n = 767 例具有临床 GCA 诊断,686 例符合 GCA ACR 标准,463 例经活检证实)。这些病例与以前无癌症的人群对照(n = 1437、1284、895)相匹配。我们发现 GCA 患者与人群对照相比,在诊断/匹配后的恶性肿瘤风险无显著差异(p > 0.05)。
在这项对大型、特征明确的 GCA 患者队列的研究中,GCA 患者与匹配的人群对照相比,恶性肿瘤的风险没有差异。