Risk of malignancy in scleroderma - A population-based cohort study
Risk of malignancy in scleroderma - A population-based cohort study
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DOI：
10.1002/art.21225
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发表时间：
2005-08-01
影响因子：
--
通讯作者：
Mayes, MD
中科院分区：
文献类型：
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作者：
Chatterjee, S;Dombi, GW;Mayes, MD
目标。确定硬皮病(系统性硬化症)患者的癌症发病率，并将其与当地人群的癌症发病率进行比较。底特律大都会地区硬皮病患者的癌症风险是通过将密歇根州硬皮病登记处的患者识别代码与底特律大都会癌症监测系统数据库联系起来进行评估的。在1973年至2002年间对患者进行了筛查，并在2004年进行了额外的随访。计算选定恶性肿瘤(肺癌、肝癌、结肠癌、乳腺癌、宫颈癌和前列腺癌，以及非霍奇金淋巴瘤)的标准化发病率(SIRS)，并按性别和种族进行分层。在硬皮病登记处的934名患者中，538名纳入了基于三县居住地的研究(436名女性和102名男性)。其中，首发恶性肿瘤45例(女性37例，男性8例)。硬皮病患者中肺癌(10例)是最常见的癌症。然而，它的发病率与底特律大都会人口中的发病率(SIR 1.23)没有显著差异。调查了其他类型的癌症，与当地人群的发病率相比没有显著差异，但有1个例外：患有硬皮病的黑人女性肝癌的发病率显著高于当地人群(SIR 45.8)。与之前的研究相反，这项研究没有发现硬皮病患者癌症发病率增加的统计证据，除了肝癌。一个可能的原因是底特律大都会地区某些癌症的高背景率。在比较不同的硬皮病队列时，可能有必要考虑局部癌变率。
Objective. To determine the incidence of cancer in patients with scleroderma (systemic sclerosis) and to compare those rates with cancer rates in the local population.Methods. Cancer risk in scleroderma patients in the Detroit metropolitan area was assessed by linking patient identification codes of the Michigan Scleroderma Registry to the Metropolitan Detroit Cancer Surveillance System database. Patients were screened between the years 1973 and 2002, with additional follow-up to 2004. Standardized incidence ratios (SIRs) were calculated for selected malignancies (lung, liver, colon, breast, cervical, and prostate cancers, and nonHodgkin's lymphomas), with stratification by sex and race.Results. Of 934 patients in the Scleroderma Registry, 538 were included in the study based on tri-county residency (436 females and 102 males). Of these, 45 first malignancies were noted (37 females and 8 males). Lung cancer (10 cases) was found to be the most common cancer in scleroderma patients. However, its incidence was not significantly different from that in the general population of metropolitan Detroit (SIR 1.23). Other types of cancer were examined, and no significant differences were found as compared with the rates in the local population, with I exception: black females with scleroderma had significantly higher rates of liver cancer (SIR 45.8).Conclusion. Contrary to previous studies, this study did not find statistical evidence of an increased incidence of cancer in scleroderma patients, except for liver cancer. One possible reason is the high background rates of certain cancers in the metropolitan Detroit area. It may be necessary to consider local cancer rates when comparing different scleroderma cohorts.