Peng Yezi, Chen Jiana, Ren Yafei, Yang Dan, Zhou Ziyue, Shen Xiangyi, Qian Junyan, Jiang Xu, Zhao Lidan, Fei Yunyun, Chen Hua, Li Mengtao, Yang Huaxia, Zhang Fengchun
Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Int J Rheum Dis. 2025 Jan;28(1):e70059. doi: 10.1111/1756-185X.70059.
This study aimed to investigate the mortality, survival rates, and prognostic indicators of cancer occurrence after Sjögren's syndrome (SS-CA).
The medical records of patients with SS-CA at the Peking Union Medical College Hospital (PUMCH) between January 2010 and August 2022 were retrieved. Clinical data and survival outcomes were compared to controls. The standard mortality ratio (SMR) versus the general population was calculated, and the survival and predictive markers of prognosis were analyzed using Kaplan-Meier curves and Cox regression.
In total, 114 SS-CA patients were included, with a median follow-up time of 105.1 (57.3-168.0) months. Non-Hodgkin lymphoma (32, 28.1%) was the most common cancer in patients with SS-CA. The SMR of SS-CA patients was 2.61 (95% confidence interval [CI] 1.73-3.77). Patients with SS-CA exhibited significantly inferior outcomes compared to controls (p = 0.010), with 5- and 10-year overall survival rates of 91.2% and 83.2%, respectively. SS patients with a diagnostic interval between SS and cancer (SS-CA diagnostic interval) ≤ 3 years or with hematological malignancies had poorer survival compared to those with a diagnostic interval > 3 years (p < 0.001) or with solid tumors (p = 0.019). Multivariate Cox regression analysis identified the prognosis-associated factors of SS-CA as age at SS diagnosis > 50 years (HR 3.129, 95% CI 1.224-7.998; p = 0.017), SS-CA diagnostic interval ≤ 3 years (HR 7.754, 95% CI 1.953-30.781; p = 0.004), and hematological malignancies (HR 2.648, 95% CI 1.201-5.838; p = 0.016).
Malignant comorbidities constituted a poor prognosis in patients with SS, wherein the SS-CA diagnostic interval and the types of cancer were associated with survival.
本研究旨在调查干燥综合征继发癌症（SS-CA）后的死亡率、生存率及预后指标。
检索2010年1月至2022年8月在北京协和医院的SS-CA患者的病历。将临床数据和生存结果与对照组进行比较。计算相对于普通人群的标准化死亡比（SMR），并使用Kaplan-Meier曲线和Cox回归分析生存及预后预测标志物。
共纳入114例SS-CA患者，中位随访时间为105.1（57.3 - 168.0）个月。非霍奇金淋巴瘤（32例，28.1%）是SS-CA患者中最常见的癌症。SS-CA患者的SMR为2.61（95%置信区间[CI] 1.73 - 3.77）。与对照组相比，SS-CA患者的结局显著较差（p = 0.010），5年和10年总生存率分别为91.2%和83.2%。与诊断间隔>3年（p < 0.001）或患有实体瘤（p = 0.019）的患者相比，SS与癌症诊断间隔（SS-CA诊断间隔）≤3年或患有血液系统恶性肿瘤的SS患者生存率较差。多因素Cox回归分析确定SS-CA的预后相关因素为SS诊断时年龄>50岁（HR 3.129，95% CI 1.224 - 7.998；p = 0.017）、SS-CA诊断间隔≤3年（HR 7.754，95% CI 1.953 - 30.781；p = 0.004）和血液系统恶性肿瘤（HR 2.648，95% CI 1.201 - 5.838；p = 0.016）。
恶性合并症在SS患者中预后较差，其中SS-CA诊断间隔和癌症类型与生存相关。
