Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building, Center Tower, Suite 4100, Baltimore, MD 21224, USA.
Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building, Center Tower, Suite 4100, Baltimore, MD 21224, USA.
Rheum Dis Clin North Am. 2020 Aug;46(3):551-564. doi: 10.1016/j.rdc.2020.03.002. Epub 2020 Jun 10.
Individuals with scleroderma have an increased risk of cancer compared with the general population. This heightened risk may be from chronic inflammation and tissue damage, malignant transformation provoked by immunosuppressive therapies, or a common inciting factor. In unique subsets of patients with scleroderma, there is a close temporal relationship between the onset of cancer and scleroderma, suggesting cancer-induced autoimmunity. This article discusses the potential mechanistic links between cancer and scleroderma, the serologic and clinical risk factors associated with increased cancer risk in patients with scleroderma, and implications for cancer screening.
硬皮病患者的癌症发病率高于普通人群。这种风险增加可能源于慢性炎症和组织损伤、免疫抑制治疗引起的恶性转化,或是共同的激发因素。在硬皮病的某些特定患者亚群中,癌症与硬皮病的发病之间存在密切的时间关系,提示癌症引起的自身免疫。本文讨论了癌症与硬皮病之间潜在的机制联系、硬皮病患者癌症风险增加相关的血清学和临床危险因素,以及癌症筛查的意义。