Sweeney D M, Manzi S, Janosky J, Selvaggi K J, Ferri W, Medsger T A, Ramsey-Goldman R
Department of Medicine, University of Pittsburgh, School of Medicine, PA, USA.
J Rheumatol. 1995 Aug;22(8):1478-82.
To estimate the risk of malignancy in a cohort of patients with systemic lupus erythematosus (SLE) from a university medical center.
The cohort consisted of patients with lupus who were residents of Allegheny County and who were seen at the University of Pittsburgh, 1981-91. Cases of cancer were identified by a postal survey and review of medical records. The expected number of malignancies in the lupus cohort were estimated from age, sex, and race adjusted census and cancer incidence data from Allegheny County. Standardized incidence ratios and 95% confidence intervals for all cancers were calculated.
Six (2.7%) malignancies were observed in the 219 lupus patients from Allegheny County during the observation interval (1981-91) and after the first visit at the University of Pittsburgh. The expected number of malignancies was 4.42. The standardized incidence ratio for cancer in the lupus cohort from Allegheny County was 1.36 (95% confidence interval 0.50-2.96). The frequency of malignancy was not increased in the small number of patients who had received immunosuppressive drugs before the diagnosis of cancer. Non-Hodgkin's lymphoma occurred in one patient, who also had Sjögren's syndrome, and in one patient before entry into this study who was treated with FK-506 following renal transplant. No bladder cancers were observed during the study interval.
The overall frequency of malignancy was not increased in this medical center cohort of patients with lupus during a mean followup interval of 5.2 yrs. Longterm followup and a multicenter effort is needed to refine risk estimates of cancer in patients with lupus.
评估来自某大学医学中心的系统性红斑狼疮（SLE）患者队列中发生恶性肿瘤的风险。
该队列由1981年至1991年间居住在阿勒格尼县且在匹兹堡大学就诊的狼疮患者组成。通过邮政调查和病历审查来确定癌症病例。根据阿勒格尼县的年龄、性别和种族调整后的人口普查及癌症发病率数据，估算狼疮队列中恶性肿瘤的预期数量。计算所有癌症的标准化发病率比及95%置信区间。
在观察期（1981年至1991年）以及匹兹堡大学首次就诊之后，阿勒格尼县的219名狼疮患者中观察到6例（2.7%）恶性肿瘤。恶性肿瘤的预期数量为4.42。阿勒格尼县狼疮队列中癌症的标准化发病率比为1.36（95%置信区间0.50 - 2.96）。在癌症诊断前接受过免疫抑制药物治疗的少数患者中，恶性肿瘤的发生率并未增加。1例患者发生非霍奇金淋巴瘤，该患者同时患有干燥综合征；另1例在进入本研究之前的患者在肾移植后接受FK - 506治疗。在研究期间未观察到膀胱癌。
在该医学中心的狼疮患者队列中，平均随访5.2年期间，恶性肿瘤的总体发生率并未增加。需要进行长期随访和多中心研究，以完善狼疮患者癌症风险的评估。
