Treppo Elena, Toffolutti Federica, Manfrè Valeria, Taborelli Martina, De Marchi Ginevra, De Vita Salvatore, Serraino Diego, Quartuccio Luca
Division of Rheumatology, Academic Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy.
Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy.
J Clin Med. 2022 Jul 22;11(15):4272. doi: 10.3390/jcm11154272.
To evaluate cancer risk among individuals with connective tissue disease (CTD) in Friuli Venezia Giulia, northern Italy.
A population-based cohort study was conducted based on data from health records available in the regional healthcare database. Demographic characteristics, hospital discharges, exemption from medical charges, drug prescriptions, were individually matched with data from the population-based cancer registry. Cancer risk was assessed in people diagnosed with the following diseases: systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), systemic sclerosis (SSc), polymyositis (PM), and dermatomyositis (DM).
In all, 2504 patients were followed for a total of 18,006 person-years (median follow-up: 6.8 years). After 5 and 10 years of follow-up, the cumulative cancer incidence was 2.6% and 8.5%, respectively. The most common cancers were breast ( = 34), lung ( = 24), colon-rectum-anus ( = 20), and non-Hodgkin lymphomas (NHL) ( = 20). Overall, no excess cancer risk was noted (SIR = 0.87), whereas the number of observed NHL cases was more than two-fold significantly higher than expected (SIR = 2.52). The subgroup analysis showed a higher risk of NHL among SS patients (SIR = 3.84) and SLE patients (SIR = 2.69). Conversely, the study population showed a decreased risk for breast cancers (SIR = 0.61) and corpus uteri (SIR = 0.21).
The incidence of NHL was higher among patients with SS and SLE. Careful surveillance for hematological malignancies in these patients is recommended.
评估意大利北部弗留利-威尼斯朱利亚地区结缔组织病（CTD）患者的癌症风险。
基于地区医疗数据库中健康记录的数据进行一项基于人群的队列研究。将人口统计学特征、医院出院记录、医疗费用豁免情况、药物处方与基于人群的癌症登记数据进行个体匹配。对诊断患有以下疾病的人群评估癌症风险：系统性红斑狼疮（SLE）、干燥综合征（SS）、系统性硬化症（SSc）、多发性肌炎（PM）和皮肌炎（DM）。
总共对2504例患者进行了随访，总计18006人年（中位随访时间：6.8年）。随访5年和10年后，累积癌症发病率分别为2.6%和8.5%。最常见的癌症为乳腺癌（=34）、肺癌（=24）、结肠-直肠-肛门癌（=20）和非霍奇金淋巴瘤（NHL）（=20）。总体而言，未发现癌症风险增加（标准化发病比[SIR]=0.87），而观察到的NHL病例数比预期显著高出两倍多（SIR=2.52）。亚组分析显示SS患者（SIR=3.84）和SLE患者（SIR=2.69）中NHL风险较高。相反，研究人群中乳腺癌（SIR=0.61）和子宫体癌（SIR=0.21）风险降低。
SS和SLE患者中NHL发病率较高。建议对这些患者仔细监测血液系统恶性肿瘤。
