Cho Soo-Kyung, Han Jung-Yong, Jeon Yena, You Seung-Hun, Jung Sun-Young, Jang Eun Jin, Sung Yoon-Kyoung
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, 04763, South Korea.
Hanyang University Institute for Rheumatology Research, Seoul, South Korea.
Arthritis Res Ther. 2025 Jan 22;27(1):14. doi: 10.1186/s13075-025-03482-2.
To investigate cancer incidence and the potential influence of immunosuppressive agents in Korean systemic lupus erythematosus (SLE) patients.
We conducted a retrospective analysis utilizing data from the Korea Healthcare Bigdata Linked Platform, which integrated the National Central Cancer Registry and National Health Insurance Service databases covering the period 2008-2017. Incidence rates (IRs) per 10,000 person-years (PYs) for site-specific cancers of SLE patients were calculated using ICD-O-3 codes. Multivariable logistic regression analysis was utilized to assess the association between immunosuppressive agents and cancer development in SLE patients.
A total of 10,013 predominantly female (91%) Korean SLE patients with a mean age of 36.9 ± 15.2 years were included. During a follow-up of 62,268.5 PYs, 368 patients developed cancer. The IRs per 10,000 PYs for total, solid, and hematologic cancers were 59.07, 54.09, and 5.78, respectively. The most prevalent cancers (measured in IRs per 10,000 PYs) were thyroid (17.01, 95% CI 13.78-20.25), breast (8.67, 95% CI 6.36-10.98), stomach (4.49, 95% CI 2.83-6.16), colorectal (4.17, 95% CI 2.57-5.78), and cervical (3.85, 95% CI 2.31-5.39). Approximately half (50.8%) of SLE patients with cancer were diagnosed at the localized Surveillance, Epidemiology, and End Results (SEER) stage. No statistically significant association was found between immunosuppressive agents and cancer development (Odds Ratio 1.03, 95% CI 0.80-1.34).
Our study shows that Korean SLE patients using immunosuppressive agents are not significantly more likely to develop cancer. Further research with extended observation is warranted to corroborate these findings.
调查韩国系统性红斑狼疮（SLE）患者的癌症发病率以及免疫抑制剂的潜在影响。
我们利用韩国医疗大数据链接平台的数据进行了一项回顾性分析，该平台整合了2008 - 2017年期间的国家中央癌症登记处和国家健康保险服务数据库。使用ICD - O - 3编码计算SLE患者特定部位癌症的每10000人年发病率（IRs）。采用多变量逻辑回归分析评估免疫抑制剂与SLE患者癌症发生之间的关联。
共纳入10013名主要为女性（91%）的韩国SLE患者，平均年龄为36.9±15.2岁。在62268.5人年的随访期间，368名患者患癌。每10000人年的总癌症、实体癌和血液系统癌症的发病率分别为59.07、54.09和5.78。最常见的癌症（以每10000人年发病率衡量）是甲状腺癌（17.01，95%可信区间13.78 - 20.25）、乳腺癌（8.67，95%可信区间6.36 - 10.98）、胃癌（4.49，95%可信区间2.83 - 6.16）、结直肠癌（4.17，95%可信区间2.57 - 5.78）和宫颈癌（3.85，95%可信区间2.31 - 5.39）。约一半（50.8%）患癌的SLE患者在局部监测、流行病学和最终结果（SEER）阶段被诊断出来。未发现免疫抑制剂与癌症发生之间存在统计学上的显著关联（优势比1.03，95%可信区间0.80 - 1.34）。
我们的研究表明，使用免疫抑制剂的韩国SLE患者患癌的可能性并未显著增加。有必要进行进一步的长期观察研究以证实这些发现。
