Incidence of cancer in a cohort of patients with primary Sjogren's syndrome
Incidence of cancer in a cohort of patients with primary Sjogren's syndrome
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DOI：
10.1093/rheumatology/kei281
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发表时间：
2006-08-01
期刊：
影响因子：
5.5
通讯作者：
Isenberg, D. A.
中科院分区：
文献类型：
--
作者：
Lazarus, M. N.;Robinson, D.;Isenberg, D. A.
Objective.比较原发性干燥综合征（pSS）患者队列与英格兰同一地区普通人群中后续癌症的发生率。对1979年以来在伦敦大学学院医院门诊部就诊的112例患者进行了回顾性分析。从pSS诊断到首次后续癌症诊断、死亡、失访或2003年12月31日（删失日期）对患者进行随访，以确定每个个体的风险人-年。随后癌症的预期数量是根据英格兰东南部一般人群的性别/年龄/时期特异性比率计算的，这些比率来自泰晤士癌症登记处的登记。然后计算标准化发病率比（SIR），即观察到的癌症数量与预期癌症数量的比值，沿着计算95%置信区间（CI）。对所有恶性肿瘤、淋巴瘤和非淋巴癌进行单独分析。在112例pSS患者中，25例发生癌症（在pSS发生之前或之后），其中11例发生淋巴瘤。9名患者患有两种癌症。与一般人群相比，pSS患者的淋巴瘤发生率显著升高（SIR 37.5，95% CI 20.7-67.6）。对于非淋巴癌，观察到的发病率增加较小，无统计学意义（SIR 1.5，95% CI 0.9-2.6）。本研究证实pSS患者淋巴瘤的发生率增加。其他癌症发病率的增加尚未得到证实，但一些患者患上一种以上癌症的观察结果提出了一种可能性，即可能有一个亚组的患者患癌症的风险更大。
Objective. To compare the incidence of subsequent cancers in a cohort of patients with primary Sjogren's syndrome (pSS) with that of the general population in the same region of England.Methods. A retrospective analysis was carried out on 112 patients who had attended the out-patients department at University College Hospital, London, from 1979 onwards. Patients were followed up from diagnosis of pSS to diagnosis of first subsequent cancer, death, loss to follow-up or 31 December 2003 (the censoring date) to determine the person-years at risk for each individual. The expected numbers of subsequent cancers were calculated from sex-/age-/period-specific rates for the general population of southeast England, derived from registrations at the Thames Cancer Registry. Standardized incidence ratios (SIRs) were then calculated as the ratio of observed to expected numbers of cancers, along with 95% confidence intervals (CIs). Separate analyses were performed for all malignant cancers combined, lymphomas and non-lymphoid cancers.Results. Among the 112 patients with pSS, 25 developed cancer (either before or after development of pSS), with lymphoma occurring in 11 cases. Nine patients had two cancers. There was a significantly elevated incidence of lymphomas in pSS patients compared with the general population (SIR 37.5, 95% CI 20.7-67.6). For non-lymphoid cancer, the observed increase in incidence was small and not statistically significant (SIR 1.5, 95% CI 0.9-2.6).Conclusion. This study confirms that there is an increased incidence of lymphoma in patients with pSS. An increase in the incidence of other cancers was not proven but the observation that some patients developed more than one cancer raises the possibility that there may be a subgroup of patients who are at greater risk of developing cancer.