Lee Young Ho, Song Gwan Gyu
Department of Rheumatology, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, 02841, Seoul, Korea (Republic of).
Z Rheumatol. 2025 Sep 1. doi: 10.1007/s00393-025-01717-w.
To evaluate standardized incidence ratios (SIRs) of cancer in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
A systematic review and meta-analysis of studies from Medline, Embase, and Cochrane databases (inception to May 2025) was performed. Pooled SIRs were analyzed overall and by region, sex, age, AAV subtype, and cancer type.
Fourteen studies involving 5553 AAV patients and 883 cancers were included. Overall cancer risk was significantly elevated (SIR: 1.767, 95% confidence interval [CI] 1.514-2.063). Regionally, SIRs were increased in Europe (1.717), Asia (2.193), and Oceania (1.740; all p < 0.001). Age-specific analyses showed elevated risks in patients ≤ 60 years (SIR: 2.217) and > 60 years (SIR: 2.072). Notably increased risks were observed for bladder cancer (SIR: 4.291), leukemia (4.082), kidney cancer (3.202), nonmelanoma skin cancer (3.598), lung cancer (2.082), malignant melanoma (1.701), liver cancer (1.778), oral cavity (1.760), brain (1.912), and colorectal cancer (1.465). No significant increase was found for breast, prostate, stomach cancer, non-Hodgkin lymphoma (NHL), or lymphoma.
Patients with AAV face a significantly increased risk of cancer, particularly bladder, hematologic, kidney, and skin cancers. These findings support the need for tailored cancer surveillance strategies in AAV management.
评估抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）患者的癌症标准化发病率（SIR）。
对来自Medline、Embase和Cochrane数据库（从创建到2025年5月）的研究进行系统综述和荟萃分析。汇总的SIR按总体以及地区、性别、年龄、AAV亚型和癌症类型进行分析。
纳入了14项研究，涉及5553例AAV患者和883例癌症患者。总体癌症风险显著升高（SIR：1.767，95%置信区间[CI] 1.514 - 2.063）。在地区方面，欧洲（1.717）、亚洲（2.193）和大洋洲（1.740；均p < 0.001）的SIR升高。按年龄分层分析显示，≤60岁患者（SIR：2.217）和>60岁患者（SIR：2.072）的风险升高。膀胱癌（SIR：4.291）、白血病（4.082）、肾癌（3.202）、非黑色素瘤皮肤癌（3.598）、肺癌（2.082）、恶性黑色素瘤（1.701）、肝癌（1.778）、口腔癌（1.760）、脑癌（1.912）和结直肠癌（1.465）的风险显著增加。乳腺癌、前列腺癌、胃癌、非霍奇金淋巴瘤（NHL）或淋巴瘤未发现显著增加。
AAV患者面临的癌症风险显著增加，尤其是膀胱癌、血液系统癌症、肾癌和皮肤癌。这些发现支持在AAV管理中需要制定针对性的癌症监测策略。
