Jonušienė Gintarė, Kačėnienė Augustė, Gedvilaitė Vaida, Dadonienė Jolanta, Miltinienė Dalia, Deresevičienė Giedrė, Smailytė Giedrė
Antakalnis Outpatient Clinic, LT-10207, Vilnius, Lithuania.
Laboratory of Cancer Epidemiology, National Cancer Institute, 08406, Vilnius, Lithuania.
Clin Rheumatol. 2025 May 19. doi: 10.1007/s10067-025-07489-7.
Sjögren's syndrome (SjS) is a systemic autoimmune disease that predominantly affects the exocrine salivary and lacrimal glands, leading to the manifestation of classic symptoms-dry mouth and eyes. This study aims to analyze cancer risk by site among patients diagnosed with SjS using a Lithuanian population-based dataset.
The study cohort comprised all patients with an initial entry of Sjögren's syndrome (International Classification of Diseases Australian modification, ICD-10-AM diagnosis code M35.0) in the National Health Insurance Fund (NHIF) database, with the record of at least one prescription for antirheumatic medications in the NHIF database, recorded between 1 January 2012 and 31 December 2019. To determine cancer incidence within the cohort, we linked SjS records to the Lithuanian National Cancer Registry, incorporating data from the beginning of 2012 up to 31 December 2019, using personal identification numbers assigned to all Lithuanian citizens.
In total, 29 males and 280 females diagnosed with SjS were included in the final analysis. The study found an increased risk of several cancers among female patients diagnosed with SjS. Notably, there was a statistically significant higher incidence rate of non-melanoma skin cancer (SIR 3.20, 95% CI [1.52-6.71]) and non-Hodgkin lymphoma (SIR 33.11, 95% CI [17.23-63.64]). Overall, the incidence of all cancers combined was also elevated (SIR 2.11, 95% CI [1.44-3.07]).
Our study shows that there is a statistically significant increased risk of non-melanoma skin cancer and non-Hodgkin lymphoma among female patients diagnosed with Sjögren's syndrome compared to the general Lithuanian population. Key Points • The study found an increased risk of melanoma and non-Hodgkin lymphoma among female patients diagnosed with SjS. • The incidence of all cancers among female patients diagnosed with SjS was elevated. • There was an increased SIR for cancer diagnosis among patients exposed to bDMARDs during the follow-up period compared to those not exposed.
干燥综合征（SjS）是一种全身性自身免疫性疾病，主要影响外分泌唾液腺和泪腺，导致出现经典症状——口干和眼干。本研究旨在利用立陶宛基于人群的数据集，分析被诊断为干燥综合征的患者按部位划分的癌症风险。
研究队列包括在国家健康保险基金（NHIF）数据库中首次录入干燥综合征（国际疾病分类澳大利亚修订版，ICD - 10 - AM诊断代码M35.0）且在2012年1月1日至2019年12月31日期间NHIF数据库中有至少一张抗风湿药物处方记录的所有患者。为确定队列中的癌症发病率，我们使用分配给所有立陶宛公民的个人识别号码，将干燥综合征记录与立陶宛国家癌症登记处相链接，纳入2012年初至2019年12月31日的数据。
最终分析纳入了29名男性和280名被诊断为干燥综合征的女性。研究发现，被诊断为干燥综合征的女性患者患几种癌症的风险增加。值得注意的是，非黑色素瘤皮肤癌（标准化发病比3.20，95%可信区间[1.52 - 6.71]）和非霍奇金淋巴瘤（标准化发病比33.11，95%可信区间[17.23 - 63.64]）的发病率在统计学上显著更高。总体而言，所有癌症合并的发病率也有所升高（标准化发病比2.11，95%可信区间[1.44 - 3.07]）。
我们的研究表明，与立陶宛普通人群相比，被诊断为干燥综合征的女性患者患非黑色素瘤皮肤癌和非霍奇金淋巴瘤的风险在统计学上显著增加。要点 • 研究发现，被诊断为干燥综合征的女性患者患黑色素瘤和非霍奇金淋巴瘤的风险增加。 • 被诊断为干燥综合征的女性患者所有癌症的发病率有所升高。 • 与未暴露于生物制剂改善病情抗风湿药（bDMARDs）的患者相比，随访期间暴露于bDMARDs的患者癌症诊断的标准化发病比增加。
