School of Medicine, 101232University of Eastern Finland, Kuopio, Finland.
60670Jyväskylä Central Hospital, Jyväskylä, Finland.
Lupus. 2022 Dec;31(14):1750-1758. doi: 10.1177/09612033221131501. Epub 2022 Oct 6.
The objective of this study was to evaluate the incidence of malignancies among newly diagnosed systemic lupus erythematosus (SLE) patients compared to reference individuals. Another aim was to assess the survival of SLE patients with malignancy compared to references with malignancy. Finnish adult (>17 years) newly diagnosed SLE patients were identified by their drug reimbursement decisions made during 1.1.2000-31.12.2014 from the register of the Social Insurance Institution. For each case, three population controls were individually selected by age, sex and place of residence. Overall, 1006 SLE patients (women 84%), with a mean age of 45.5 years (SD 16 years) and 3005 population controls were linked to Finnish Cancer Registry, and the information about incident malignancies was retrieved from the day the special reimbursement decision for SLE medication was accepted (index day, ID) until 31.12.2018 or until death. The patients diagnosed with malignancy were followed up until 31.12.2019 considering survival. During the follow-up, 85 SLE patients (women 78%) and 192 controls (women 78%) had developed one or more malignancy after the ID. The incidence rate ratio for any malignancy was 1.41 (95% CI 1.08-1.85). The most common malignancy in SLE patients was non-Hodgkin lymphoma, with twelve cases. SLE patients with malignancy had a lower adjusted 15-year survival than controls with malignancy, 27.1% versus 52.4%, and the adjusted hazard ratio for death was 1.68 (95% CI 1.17-2.43). Our results confirm that SLE patients have a higher risk for overall malignancy. The results also suggest that SLE patients with malignancy have lower survival than their references with malignancy.
本研究旨在评估新诊断的系统性红斑狼疮（SLE）患者与对照人群相比恶性肿瘤的发病率。另一个目的是评估恶性肿瘤的 SLE 患者与恶性肿瘤对照人群相比的生存情况。通过社会保险机构的药物报销决定，于 2000 年 1 月 1 日至 2014 年 12 月 31 日期间，识别出芬兰成年（>17 岁）新诊断的 SLE 患者。为每个病例，通过年龄、性别和居住地，从人群中个体选择了 3 名对照。总共纳入了 1006 名 SLE 患者（84%为女性），平均年龄为 45.5 岁（标准差 16 岁），3005 名对照与芬兰癌症登记处相关联，并从 SLE 药物特殊报销决定被接受的那一天（索引日，ID）开始，检索到有关新发恶性肿瘤的信息，直至 2018 年 12 月 31 日或直至死亡。在考虑生存的情况下，诊断为恶性肿瘤的患者被随访至 2019 年 12 月 31 日。在随访期间，ID 后有 85 名 SLE 患者（88%为女性）和 192 名对照（88%为女性）发生了一种或多种恶性肿瘤。任何恶性肿瘤的发病率比值比为 1.41（95%CI 1.08-1.85）。SLE 患者最常见的恶性肿瘤是非霍奇金淋巴瘤，有 12 例。恶性肿瘤的 SLE 患者的 15 年调整生存率低于恶性肿瘤对照人群，分别为 27.1%和 52.4%，死亡风险的调整后危险比为 1.68（95%CI 1.17-2.43）。我们的结果证实，SLE 患者整体恶性肿瘤的风险更高。结果还表明，恶性肿瘤的 SLE 患者的生存率低于恶性肿瘤对照人群。
