Division of Internal Medicine, Department of Medicine, University of Montreal, Montreal, Quebec.
Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Curr Opin Rheumatol. 2019 Nov;31(6):678-681. doi: 10.1097/BOR.0000000000000648.
Patients with systemic lupus erythematosus (SLE) have altered incidences of certain malignancies as compared with the general population. This review summarizes the recent literature on risk of malignancy in SLE and proposed mechanisms for these altered susceptibilities.
Recent studies have confirmed previous data showing an increased risk of hematological, lung, thyroid, liver, cervical and vulvovaginal cancers, while demonstrating a decreased risk of breast and prostate cancer. Lymphomagenesis in SLE has been linked to increased activity of multiple inflammatory cytokines as well as possible viral causes. The decreased rates of hormone-sensitive cancers, such as breast and prostate is speculated to be related to the presence of lupus autoantibodies and downregulation of certain proteins in SLE. This knowledge has been utilized to investigate new therapeutic modalities for these malignancies.
Recent data confirm previously reported altered malignancy rates in SLE. There has been some elucidation of mechanisms underlying cancer development in SLE, although additional work is yet to be done.
与普通人群相比,系统性红斑狼疮(SLE)患者具有某些恶性肿瘤的发病率改变。本综述总结了 SLE 恶性肿瘤风险的最新文献,并提出了这些易感性改变的机制。
最近的研究证实了先前的数据,表明 SLE 患者发生血液系统、肺部、甲状腺、肝脏、宫颈和外阴阴道癌症的风险增加,而乳腺癌和前列腺癌的风险降低。SLE 中的淋巴瘤发生与多种炎症细胞因子的活性增加以及可能的病毒原因有关。推测狼疮自身抗体的存在和 SLE 中某些蛋白的下调与激素敏感性癌症(如乳腺癌和前列腺癌)发生率降低有关。这些知识已被用于研究这些恶性肿瘤的新治疗方法。
最近的数据证实了之前报道的 SLE 恶性肿瘤发病率改变。尽管还需要做更多的工作,但已经对 SLE 中癌症发生的机制进行了一些阐明。