Patt Yonatan Shneor, Ben-Shabat Niv, Sharif Kassem, Patt Chen, Elizur Yoav, Arow Mohamad, Cohen Arnon D, Watad Abdulla, McGonagle Dennis, Amital Howard, David Paula
Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 5262100, Israel.
Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
J Clin Med. 2024 Nov 22;13(23):7045. doi: 10.3390/jcm13237045.
Sarcoidosis is a multisystem granulomatous disorder with a variable clinical course and complications. The relationship between sarcoidosis and malignancies remains unclear, including specific malignancy associations with sarcoidosis and whether the association is short-term, long-term, or a result of misdiagnoses or coincidence. This study investigated the association between sarcoidosis and malignancy by analyzing the varying intervals between the diagnoses of these two conditions to clarify their inter-relationship. This retrospective cohort study included almost 24,000 sarcoidosis patients and matched controls at a 1:5 ratio in patients diagnosed between 2000 and 2015 in Israel. Patients had a median age of 57 years. Malignancy rates were compared across several timeframes: overall, within one year before or after sarcoidosis diagnosis and more than one year. Logistic regression models were employed to estimate odds ratios for the association between sarcoidosis and malignancy, adjusting for sociodemographic and clinical variables. Sarcoidosis patients had a significantly higher prevalence of malignancies (19.5%) compared to controls (13.6%) ( < 0.001). The association remained significant for both hematologic malignancies (OR: 2.94, 95% CI: 2.41-3.57) and solid malignancies (OR: 1.41, 95% CI: 1.27-1.55). The strongest association was observed with lymphoma, particularly within the first year of sarcoidosis diagnosis (OR: 14.88, 95% CI: 8.83-25.1). Elevated odds for malignancies persisted both within one year and beyond, including sarcoma and soft tissue cancers and genitourinary malignancies. Our study confirms a significant association between sarcoidosis and both hematologic and solid malignancies in both the short and long term across various timeframes. These findings emphasize the need for increased clinical vigilance in sarcoidosis patients and highlight the importance of further research into the shared genetic and environmental mechanisms that may underlie this relationship.
结节病是一种多系统肉芽肿性疾病，临床病程和并发症各异。结节病与恶性肿瘤之间的关系仍不明确，包括结节病与特定恶性肿瘤的关联，以及这种关联是短期的、长期的，还是误诊或巧合的结果。本研究通过分析这两种疾病诊断之间的不同时间间隔来调查结节病与恶性肿瘤之间的关联，以阐明它们的相互关系。这项回顾性队列研究纳入了近24000例结节病患者，并以1:5的比例为2000年至2015年在以色列确诊的患者匹配了对照。患者的中位年龄为57岁。在几个时间范围内比较了恶性肿瘤发生率：总体情况、结节病诊断前或后的一年内以及一年以上。采用逻辑回归模型估计结节病与恶性肿瘤之间关联的比值比，并对社会人口统计学和临床变量进行了调整。与对照组（13.6%）相比，结节病患者的恶性肿瘤患病率显著更高（19.5%）（<0.001）。血液系统恶性肿瘤（比值比：2.94，95%置信区间：2.41-3.57）和实体恶性肿瘤（比值比：1.41，95%置信区间：1.27-1.55）的关联均保持显著。与淋巴瘤的关联最为强烈，尤其是在结节病诊断后的第一年内（比值比：14.88，95%置信区间：8.83-25.1）。恶性肿瘤的较高比值在一年内及以后均持续存在，包括肉瘤、软组织癌和泌尿生殖系统恶性肿瘤。我们的研究证实，在不同时间范围内，结节病与血液系统和实体恶性肿瘤在短期和长期均存在显著关联。这些发现强调了对结节病患者提高临床警惕性的必要性，并突出了进一步研究可能构成这种关系基础的共同遗传和环境机制的重要性。
