日前，一則發(fā)表在Br J Dermatol雜志上的研究"Increased risk of cancer among 3,663 patients with cutaneous lupus erythematosus- a Swedish nationwide cohort study"證明皮膚型狼瘡患者患惡性腫瘤的風(fēng)險(xiǎn)增加,。
多種自身免疫疾病與惡性腫瘤的發(fā)生相關(guān),，有很多病例報(bào)告提示皮膚紅斑狼瘡（CLE）與多種不同的惡性腫瘤相關(guān)。研究者通過全瑞典范圍內(nèi)對(duì)診斷CLE的患者與未診斷CLE的對(duì)照組進(jìn)行隊(duì)列研究,，來評(píng)判CLE患者惡性腫瘤總的發(fā)生風(fēng)險(xiǎn)及其類型,。
本研究共納入3663例確診CLE的患者，從正常人群中篩選與之匹配的對(duì)照組（對(duì)照組與病例組比例為3：1）,。所有資料來源于1997-2007年間瑞士全國(guó)病人登記系統(tǒng),，并與瑞士全國(guó)癌癥登記系統(tǒng)及瑞士全國(guó)死因登記系統(tǒng)相聯(lián)網(wǎng),。對(duì)惡性腫瘤病例數(shù)的觀測(cè)值與預(yù)測(cè)值進(jìn)行風(fēng)險(xiǎn)比（HRs）及95%置信區(qū)間（CIs）的計(jì)算。在整個(gè)研究期間共有183例惡性腫瘤報(bào)告,，HR為1.8（95%CI為1.5-2.2）,。中位隨訪時(shí)間為4.1年?？谇粣盒阅[瘤,，淋巴瘤，呼吸系統(tǒng)惡性腫瘤及非惡性黑色素瘤皮膚惡性腫瘤的發(fā)生風(fēng)險(xiǎn)大約為正常人群的4倍,。
因此,，CLE患者具有罹患某些惡性腫瘤的較高風(fēng)險(xiǎn)，除外了同時(shí)患有系統(tǒng)性紅斑狼瘡的患者,，這種風(fēng)險(xiǎn)依然存在。研究強(qiáng)調(diào)了CLE患者戒煙,、避免日曬的重要性,，并且指出這些患者需要自實(shí)驗(yàn)室到臨床的密切監(jiān)測(cè)以評(píng)估其發(fā)病的病理過程。（生物谷Bioon.com）
doi:10.1111/j.1365-2133.2011.10773.x
PMC:
PMID:
Increased risk of cancer among 3,663 patients with cutaneous lupus erythematosus- a Swedish nationwide cohort study.
Grönhagen CM, Fored CM, Granath F, Nyberg F.
Background: Other autoimmune diseases have been associated with higher risks for cancer and numerous case reports of cutaneous lupus erythematosus (CLE) and different cancer types are available. Objective: To estimate the overall and specific cancer risks in a nationwide cohort study of patients diagnosed with CLE in Sweden and compare that risk with a control cohort without CLE. Methods: A cohort of 3,663 individuals with CLE and a matched control cohort from the general population (three controls to each CLE case) without a diagnosis of CLE were derived from the National Swedish Patient Register, 1997-2007, and were electronically linked to the National Swedish Cancer Register and the Swedish Cause of Death Register. Hazard Ratios (HRs) and 95% confidence intervals (CIs) were calculated to compare the observed to the expected numbers of cancers. Results: A total of 183 incident cancers occurred within the observation interval, yielding a HR of 1.8 (95% CI 1.5-2.2) for cancer overall. Median follow-up was 4.1 years. About a four-fold risk increase were seen for buccal cancer, lymphomas, respiratory cancer and non-melanoma skin cancer. Conclusions: Patients with CLE appear to have an elevated risk for certain cancer types, an increase that remains when excluding patients also diagnosed with systemic lupus erythematosus. Our findings point to the importance of counselling about non-smoking and sun-avoidance and underscore the need for specialised monitoring of this patient group along with bench-to-bedside research efforts to clarify pathogenesis
