High Incidence of Potentially Virus-Induced Malignancies in Systemic Lupus Erythematosus A Long-Term Followup Study in a Danish Cohort
High Incidence of Potentially Virus-Induced Malignancies in Systemic Lupus Erythematosus A Long-Term Followup Study in a Danish Cohort
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DOI：
10.1002/art.30483
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发表时间：
2011-10-01
影响因子：
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通讯作者：
Jacobsen, Soren
中科院分区：
文献类型：
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作者：
Dreyer, Lene;Faurschou, Mikkel;Jacobsen, Soren
Objective.系统性红斑狼疮（SLE）患者似乎经历了致癌病毒感染的患病率增加。本研究的目的是调查SLE患者是否有病毒相关恶性肿瘤的风险增加，定义为恶性肿瘤可能引起的病毒感染。一个以医院为基础的576例SLE患者队列与丹麦癌症登记处相关联。从SLE诊断之日起对队列进行恶性肿瘤随访，并计算各种癌症的标准化发病率比（SIRs）。中位随访时间为13.2年。与一般人群相比，患者发生癌症的总体风险增加（SIR 1.6 [95%置信区间（95% CI）] 1.2-2.0）。我们观察到合并病毒相关癌症的风险增加（SIR 2.9 [95% CI 2.0-4.1]）。在人乳头瘤病毒（HPV）相关的恶性和癌前病变中，发现肛门癌的风险较高（SIR 26.9 [95% CI 8.7-83.4]），阴道/外阴癌（SIR 9.1 [95% CI 2.3-36.5]），宫颈上皮异型增生/原位癌（SIR 1.8 [95% CI 1.2-2.7]）和非黑色素瘤皮肤癌（SIR 2.0 [95% CI 1.2-3.6]）。其他潜在病毒诱导的癌症类型也发现SIR增加（肝癌SIR 9.9 [95%CI 2.5-39.8]，膀胱癌SIR 3.6 [95%CI 1.4-9.7]，非霍奇金淋巴瘤SIR 5.0 [95%CI 1.9-13.3]）。在长期随访中，该SLE队列中的患者发生HPV相关肿瘤和其他潜在病毒诱导癌症的风险增加。我们的研究结果呼吁临床警惕SLE患者的致癌病毒感染。
Objective. Patients with systemic lupus erythematosus (SLE) seem to experience an increased prevalence of oncogenic virus infections. The aim of the present study was to investigate whether SLE patients have an increased risk of virus-associated malignancies, defined as malignancies potentially caused by virus infection.Methods. A hospital-based cohort of 576 SLE patients was linked to the Danish Cancer Registry. The cohort was followed up for malignancies from the date of SLE diagnosis, and standardized incidence ratios (SIRs) were calculated for various forms of cancer.Results. The median duration of followup was 13.2 years. Compared to the general population, the patients experienced an increased overall risk of cancer (SIR 1.6 [95% confidence interval (95% CI)] 1.2-2.0). We observed an increased risk of virus-associated cancers combined (SIR 2.9 [95% CI 2.0-4.1]). Among human papillomavirus (HPV)-associated malignant and premalignant conditions, high risk was found for anal cancer (SIR 26.9 [95% CI 8.7-83.4]), vaginal/vulvar cancer (SIR 9.1 [95% CI 2.3-36.5]), epithelial dysplasia/carcinoma in situ of the uterine cervix (SIR 1.8 [95% CI 1.2-2.7]), and nonmelanoma skin cancer (SIR 2.0 [95% CI 1.2-3.6]). Increased SIRs were also found for other potentially virus-induced cancer types (liver cancer SIR 9.9 [95% CI 2.5-39.8], bladder cancer SIR 3.6 [95% CI 1.4-9.7], and non-Hodgkin's lymphoma SIR 5.0 [95% CI 1.9-13.3]).Conclusion. The patients in this SLE cohort experienced an increased risk of HPV-associated tumors and other potentially virus-induced cancers during long-term followup. Our findings call for clinical alertness to oncogenic virus infections in SLE patients.