First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, "Laiko" General Hospital , Athens, Greece.
Department of Rheumatology, Faculty of Medicine, Patras University Hospital, University of Patras Medical School , Patras, Greece.
Expert Rev Clin Immunol. 2020 Dec;16(12):1105-1113. doi: 10.1080/1744666X.2021.1847641. Epub 2020 Nov 16.
: Systemic sclerosis (SSc) is associated with a heightened cancer risk compared to the general population. Several pathways including immune system upregulation, cumulative inflammation, environmental factors, and genetic predisposition contribute to the development of both cancer and autoimmunity. : This paper provides an overview of studies investigating the relationship between SSc and various types of cancer with a special focus on the identification of patients at higher risk for malignancy development. The demographic, serological, clinical, and disease-related characteristics of SSc individuals who are diagnosed with cancer over the course of their disease are discussed to provide a practical guidance for relevant screening strategies. : Several studies have identified subgroups of SSc patients at higher cancer risk based on the immunological profile (anti-RNAPol III positivity), diffuse disease type, and older age at SSc onset. Additionally, a close temporal association between SSc and cancer onset in certain antibody subsets raises the question as to whether more aggressive screening strategies should be considered. Currently, there are no published studies investigating the cost-effectiveness, efficacy, and safety of a targeted cancer-detection program. Screening procedures should at least follow recommendations for the general population with a special focus on patients at higher risk and specific cancer types.
系统性硬化症（SSc）与一般人群相比，癌症风险增加。包括免疫系统上调、累积炎症、环境因素和遗传易感性在内的几种途径都可能导致癌症和自身免疫的发生。
本文概述了研究 SSc 与各种类型癌症之间关系的研究，特别关注确定发生恶性肿瘤风险较高的患者。讨论了在疾病过程中被诊断患有癌症的 SSc 个体的人口统计学、血清学、临床和疾病相关特征，为相关筛查策略提供了实用指导。
几项研究基于免疫学特征（抗 RNA 聚合酶 III 阳性）、弥漫性疾病类型和 SSc 发病年龄较大，确定了癌症风险较高的 SSc 患者亚组。此外，某些抗体亚群中 SSc 和癌症发病之间的密切时间关联提出了一个问题，即是否应考虑更积极的筛查策略。目前，尚无研究探讨靶向癌症检测计划的成本效益、疗效和安全性。筛查程序至少应遵循针对一般人群的建议，特别关注风险较高的患者和特定癌症类型。
