系统性红斑狼疮患者患恶性肿瘤风险增加。

Increased risk of malignancy in patients with systemic lupus erythematosus.

作者信息

Ramsey-Goldman R, Mattai S A, Schilling E, Chiu Y L, Alo C J, Howe H L, Manzi S

机构信息

Department of Medicine, Northwestern University, Chicago, IL 60611-3008, USA.

出版信息

J Investig Med. 1998 Jun;46(5):217-22.

PMID:9676054

Abstract

BACKGROUND

Systemic lupus erythematosus is a chronic, multisystem, autoimmune disorder that primarily affects women. Morbidity and mortality have improved for lupus patients during the last 15 years. An increased risk of malignancy in patients with lupus has been shown in some, but not all studies. The purpose of this study was to ascertain cancer risk in lupus patients by linking two disease registries.

METHODS

Participants in the Chicago Lupus Cohort included 616 women with lupus who were residents of Cook County, Illinois. They were seen during 1985-1995 at 4 University, inner city, and suburban inpatient and outpatient clinics in Chicago. Malignancies occurring in these subjects during the study interval, 1985-1995, were identified from the Illinois State Cancer Registry by matching name, birthdate, and social security number. Standardized incidence ratios (SIRs) were estimated for all malignancies in this cohort of lupus patients using age, gender, and all race or race-stratified specific cancer incidence data from Cook County, Illinois.

RESULTS

The registry linkage study with the Illinois State Cancer Registry documented that 30 women with lupus had a malignancy. The expected number of malignancies for women in the lupus cohort was 15.0. There were 8 cases of breast cancer and 4 each of lung and cervical cancer. In the remaining 14 women, 12 different types of cancers were noted. The SIR and 95% confidence interval (CI) for malignancy for all women with lupus in the study were 2.0 (1.4, 2.9) and lung cancer was the only individual cancer increased in all women--SIR and 95% CI were 3.1 (1.3, 7.9). In the analysis stratified by race, the risk of malignancy (SIR and 95% CI) was increased in Caucasian women, 2.3 (1.4, 3.9). Breast cancer was the only individual cancer increased in Caucasian women with lupus with an SIR and 95% CI of 2.9 (1.4, 6.4).

CONCLUSIONS

Lupus patients have an increased risk of malignancy. Breast, lung, and gynecological malignancies were the most common malignancies observed in the cohort and breast cancer was significantly increased in Caucasian women.

摘要

背景

系统性红斑狼疮是一种主要影响女性的慢性、多系统自身免疫性疾病。在过去15年中，狼疮患者的发病率和死亡率有所改善。一些但并非所有研究都表明狼疮患者患恶性肿瘤的风险增加。本研究的目的是通过关联两个疾病登记处来确定狼疮患者的癌症风险。

方法

芝加哥狼疮队列的参与者包括616名患有狼疮的女性，她们是伊利诺伊州库克县的居民。她们于1985年至1995年期间在芝加哥的4所大学、市中心和郊区的住院和门诊诊所就诊。通过匹配姓名、出生日期和社会安全号码，从伊利诺伊州癌症登记处识别出这些受试者在1985年至1995年研究期间发生的恶性肿瘤。使用伊利诺伊州库克县的年龄、性别以及所有种族或按种族分层的特定癌症发病率数据，估计该狼疮患者队列中所有恶性肿瘤的标准化发病率（SIR）。

结果

与伊利诺伊州癌症登记处的登记关联研究记录显示，30名患有狼疮的女性患有恶性肿瘤。狼疮队列中女性恶性肿瘤的预期数量为15.0例。有8例乳腺癌，肺癌和宫颈癌各4例。在其余14名女性中，发现了12种不同类型的癌症。研究中所有狼疮女性的恶性肿瘤SIR和95%置信区间（CI）为2.0（1.4，2.9），肺癌是所有女性中唯一增加的个体癌症——SIR和95%CI为3.1（1.3，7.9）。在按种族分层的分析中，白人女性患恶性肿瘤的风险（SIR和95%CI）增加，为2.3（1.4，3.9）。乳腺癌是患有狼疮的白人女性中唯一增加的个体癌症，SIR和95%CI为2.9（1.4，6.4）。