From the Division of Immunology, Department of Pediatrics, Kuo General Hospital; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University; Division of Allergy, Immunology and Rheumatology, and Department of Pediatrics, Department of Internal Medicine, and Department of Statistics, National Cheng Kung University Hospital, Tainan, Taiwan.
L.H. Wang, MD, MS, Immunologist, Division of Immunology, Department of Pediatrics, Kuo General Hospital; W.M. Wang, MS, Biostatistician, National Cheng Kung University, Department of Statistics; C.Y. Lin, MD, Rheumatologist, National Cheng Kung University Hospital, Department of Internal Medicine; S.H. Lin, PhD, Associate Professor of Biostatistics, National Cheng Kung University College of Medicine, Institute of Clinical Medicine; C.C. Shieh, MD, PhD, Professor of Immunology, Rheumatology, and Pediatrics, National Cheng Kung University College of Medicine, Institute of Clinical Medicine.
J Rheumatol. 2020 Sep 1;47(9):1374-1378. doi: 10.3899/jrheum.191027. Epub 2020 Jan 15.
Bidirectional relationships between some autoimmune diseases and non-Hodgkin lymphoma (NHL) may exist. We conducted this nationwide population-based study in Taiwan to investigate whether there is a bidirectional relationship between primary Sjögren syndrome (pSS) and NHL.
Using the National Health Insurance Research Database of Taiwan, we identified 15,636 patients with new-onset pSS without previous cancer and 25,074 patients with new-onset NHL without previous pSS as 2 non-overlapping cohorts from 1998 to 2012, and followed them until 2013. Standardized incidence ratios (SIR) for NHL in the patients with pSS and SIR for pSS in the patients with NHL were compared with the general population.
Among the 15,636 patients with pSS, 741 developed cancers, including 51 with NHL. The highest SIR of specific cancer risk in patients with pSS was that for NHL (SIR 4.6, 95% CI 3.4-6.0). Among the 25,074 patients with NHL, 49 developed pSS; the SIR was also increased (SIR 3.2, 95% CI 2.4-4.2). The risk was highest within 1 year after the diagnosis of each disease.
This nationwide population-based study is the first to report a bidirectional relationship between pSS and NHL. Our findings suggest being alert for patients with pSS or NHL who have early signs of the other disease in clinical care. The underlying mechanisms of the bidirectional relationship merit further investigation.
一些自身免疫性疾病与非霍奇金淋巴瘤（NHL）之间可能存在双向关系。我们在台湾进行了这项全国性的基于人群的研究，以调查原发性干燥综合征（pSS）与 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 15636 例无既往癌症的新发 pSS 患者和 25074 例无既往 pSS 的新发 NHL 患者作为 2 个非重叠队列，并随访至 2013 年。pSS 患者中 NHL 的标准化发病比（SIR）和 NHL 患者中 pSS 的 SIR 与一般人群进行了比较。
在 15636 例 pSS 患者中，有 741 例发生癌症，其中 51 例为 NHL。pSS 患者特定癌症风险的最高 SIR 为 NHL（SIR4.6，95%CI3.4-6.0）。在 25074 例 NHL 患者中，有 49 例发生 pSS；SIR 也增加（SIR3.2，95%CI2.4-4.2）。每种疾病诊断后 1 年内风险最高。
这项全国性的基于人群的研究首次报告了 pSS 与 NHL 之间的双向关系。我们的研究结果表明，在临床护理中，对于有其他疾病早期迹象的 pSS 或 NHL 患者，应保持警惕。双向关系的潜在机制值得进一步研究。
