Effect of autoimmune diseases on risk and survival in histology-specific lung cancer
Effect of autoimmune diseases on risk and survival in histology-specific lung cancer
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DOI：
10.1183/09031936.00222911
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发表时间：
2012-12-01
影响因子：
24.3
通讯作者：
Sundquist, Kristina
中科院分区：
文献类型：
--
作者：
Hemminki, Kari;Liu, Xiangdong;Sundquist, Kristina
由于免疫系统或治疗的潜在失调，患有自身免疫性疾病的患者患癌症的风险增加。关于自身免疫性疾病后癌症发病率、死亡率和生存率的数据将提供有关临床意义的进一步信息。我们系统地分析了被诊断患有 33 种不同自身免疫性疾病的患者的肺癌数据。计算1964年之后因自身免疫性疾病住院患者至2008年的后续肺癌发生率或肺癌死亡的标准化发病率（SIR）、标准化死亡率（SMR）和风险比（HR）。记录了12种自身免疫性疾病后的SIR、11种自身免疫性疾病后的SMR和2种自身免疫性疾病后的HR的肺癌风险增加。最高的 SIR 和 SMR 分别出现在盘状红斑狼疮（4.71 和 4.80）、多发性肌病/皮肌炎（4.20 和 4.17）、系统性红斑狼疮（2.47 和 2.69）、风湿热（2.07 和 2.07）和系统性硬化症（2.19 和 2.19）之后。 1.98）。自身免疫性疾病并不影响整体生存，但一些自身免疫性疾病似乎会损害小细胞癌的生存。已知所有 SIR > 2.0 的自身免疫性疾病都会出现肺部表现，表明自身免疫过程会导致肺癌易感性。生存数据令人放心，自身免疫性疾病不会影响肺癌的预后。
Patients with autoimmune diseases are at an increased risk of cancer due to underlying dysregulation of the immune system or treatment. Data on cancer incidence, mortality and survival after autoimmune diseases would provide further information on the clinical implications.We systematically analysed data on lung cancer in patients diagnosed with 33 different autoimmune diseases. Standardised incidence ratios (SIRs), standardised mortality ratios (SMRs) and hazard ratios (HRs) were calculated for subsequent incident lung cancers or lung cancer deaths up to 2008 in patients hospitalised for autoimmune disease after 1964.Increased risks of lung cancer were recorded for SIRs after 12 autoimmune diseases, SMRs after 11 autoimmune diseases and HRs after two autoimmune diseases. The highest SIRs and SMRs, respectively, were seen after discoid lupus erythematosus (4.71 and 4.80), polymyosistis/dermatomyositis (4.20 and 4.17), systemic lupus erythematosus (2.47 and 2.69), rheumatic fever (2.07 and 2.07) and systemic sclerosis (2.19 and 1.98). Autoimmune disease did not influence survival overall but some autoimmune diseases appeared to impair survival in small cell carcinoma.All autoimmune diseases that had an SIR >2.0 are known to present with lung manifestations, suggesting that the autoimmune process contributes to lung cancer susceptibility. The data on survival are reassuring that autoimmune diseases do not influence prognosis in lung cancer.