Cancer risk in systemic lupus: an updated international multi-centre cohort study.
Cancer risk in systemic lupus: an updated international multi-centre cohort study.
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DOI：
10.1016/j.jaut.2012.12.009
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发表时间：
2013-05
影响因子：
12.8
通讯作者：
Clarke AE
中科院分区：
文献类型：
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作者：
Bernatsky S;Ramsey-Goldman R;Labrecque J;Joseph L;Boivin JF;Petri M;Zoma A;Manzi S;Urowitz MB;Gladman D;Fortin PR;Ginzler E;Yelin E;Bae SC;Wallace DJ;Edworthy S;Jacobsen S;Gordon C;Dooley MA;Peschken CA;Hanly JG;Alarcón GS;Nived O;Ruiz-Irastorza G;Isenberg D;Rahman A;Witte T;Aranow C;Kamen DL;Steinsson K;Askanase A;Barr S;Criswell LA;Sturfelt G;Patel NM;Senécal JL;Zummer M;Pope JE;Ensworth S;El-Gabalawy H;McCarthy T;Dreyer L;Sibley J;St Pierre Y;Clarke AE
更新SLE相对于普通人群的癌症风险估计。多中心国际SLE队列与区域肿瘤登记相关。标准化发病率（SIR）计算为观察到的癌症与预期癌症的比率。在30个中心中，观察了16，409例患者，共121，283（平均7.4）人年。共发生644例癌症。一些癌症，特别是血液系统恶性肿瘤，显著增加（SIR 3.02，95%置信区间，CI，2.48，3.63），特别是非霍奇金淋巴瘤、NHL（SIR 4.39，95% CI 3.46，5.49）和白血病。此外，提示外阴癌（SIR 3.78，95% CI 1.52，7.78）、肺癌（SIR 1.30，95% CI 1.04，1.60）、甲状腺癌（SIR 1.76，95% CI 1.13，2.61）和可能的肝癌（SIR 1.87，95% CI 0.97，3.27）的风险增加。然而，估计乳腺癌（SIR0.73，95%CI 0.61-0.88）、子宫内膜癌（SIR0.44，95%CI 0.23-0.77）和可能的卵巢癌（0.64，95%CI 0.34-1.10）的风险降低。不同癌症之间的比较率的变异性意味着所有癌症的风险估计仅略有增加（SIR 1.14，95% CI 1.05，1.23）。这些数据估计，SLE患者（与一般人群相比）患癌症的风险总体上只有小幅增加。然而，NHL和外阴癌、肺癌、甲状腺癌以及可能的肝癌的风险明显增加。目前尚不清楚在何种程度上与NHL的关联是由先天因素与外源性因素介导的。同样，乳腺癌、子宫内膜癌和可能的卵巢癌风险降低的病因尚不确定，尽管调查仍在进行中。
To update estimates of cancer risk in SLE relative to the general population. A multisite international SLE cohort was linked with regional tumor registries. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers. Across 30 centres, 16,409 patients were observed for 121,283 (average 7.4) person-years. In total, 644 cancers occurred. Some cancers, notably hematologic malignancies, were substantially increased (SIR 3.02, 95% confidence interval, CI, 2.48, 3.63), particularly non-Hodgkin’s lymphoma, NHL (SIR 4.39, 95% CI 3.46, 5.49) and leukemia. In addition, increased risks of cancer of the vulva (SIR 3.78, 95% CI 1.52, 7.78), lung (SIR 1.30, 95% CI 1.04, 1.60), thyroid (SIR 1.76, 95% CI 1.13, 2.61) and possibly liver (SIR 1.87, 95% CI 0.97, 3.27) were suggested. However, a decreased risk was estimated for breast (SIR 0.73, 95% CI 0.61–0.88), endometrial (SIR 0.44, 95% CI 0.23–0.77), and possibly ovarian cancers (0.64, 95% CI 0.34–1.10). The variability of comparative rates across different cancers meant that only a small increased risk was estimated across all cancers (SIR 1.14, 95% CI 1.05, 1.23). These data estimate only a small increased risk in SLE (versus the general population) for cancer over-all. However, there is clearly an increased risk of NHL, and cancers of the vulva, lung, thyroid, and possibly liver. It remains unclear to what extent the association with NHL is mediated by innate versus exogenous factors. Similarly, the etiology of the decreased breast, endometrial, and possibly ovarian cancer risk is uncertain, though investigations are ongoing.
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影响因子：
--
作者：
AbuShakra, M;Gladman, DD;Urowitz, MB
通讯作者：
Urowitz, MB
影响因子：
5.8
作者：
Antonelli, Alessandro;Mosca, Marta;Bombardieri, Stefano
通讯作者：
Bombardieri, Stefano
影响因子：
27.4
作者：
Bernatsky, S.;Joseph, L.;Clarke, A. E.
通讯作者：
Clarke, A. E.
影响因子：
3.9
作者：
Lofstrom, Bjorn;Backlin, Carin;Baecklund, Eva
通讯作者：
Baecklund, Eva
影响因子：
8.8
作者：
Akhmedkhanov, A;Toniolo, P;Shore, RE
通讯作者：
Shore, RE