系统性红斑狼疮合并肿瘤患者的临床特点及危险因素分析

Clinical characteristics and risk factors of patients with systemic lupus erythematosus and cancer

分析系统性红斑狼疮(SLE)合并肿瘤患者的临床特点及危险因素。选2010年10月至2019年2月郑州大学第一附属医院住院的SLE患者138例,SLE合并肿瘤患者69例,分析其临床特点、既往治疗及危险因素。结果显示,SLE合并肿瘤者,最常见的肿瘤为宫颈癌(21.74%,15/69)和甲状腺癌(21.74%,15/69)。SLE合并肿瘤者中,年龄以40~50岁多见,SLE诊断年龄以40~50岁多见,SLE病程以60~120个月为主。SLE者年龄以20~30岁多见,SLE诊断年龄以20~30岁多见,SLE病程以<12个月为主。两者既往使用糖皮质激素、环磷酰胺、甲氨蝶呤、硫唑嘌呤的比例差异均无统计学意义(P>0.05);SLE者既往使用羟氯喹的比例高于SLE合并肿瘤者,差异有统计学意义(P<0.01)。多因素分析显示,SLE病程(OR=4.25,95%CI 1.79~10.01,P<0.001)、羟氯喹(OR=0.26,95%CI 0.12~0.59,P<0.001)与肿瘤风险有相关性。SLE病程长可能是SLE发生肿瘤的危险因素,羟氯喹可能是保护性因素。

To investigate the clinical manifestations and risk factors in patients with systemic lupus erythematosus(SLE)and cancers.From October 2010 to February 2019,5566 SLE patients hospitalized in the First Affiliated Hospital of Zhengzhou University were enrolled.A total of 69 cancer patients were identified,and the clinical characteristics and previous treatment were analyzed.Cervical carcinoma(21.74%,15/69)and thyroid cancer(21.74%,15/69)were the most common types of cancer.Most cancers were diagnosed in SLE patients with an age 40~50 years.The disease duration of SLE was from 60~120 months.SLE patients without cancers were usually diagnosed between 20~30 years with duration of symptoms less than 12 months.As to the previous treatment of SLE,the uses of glucocorticoid,cyclophosphamide,methotrexate and azathioprine were comparable between patients with cancers and without(P>0.05).However,the use of hydroxychloroquine was more frequent in SLE patients than in patients with cancers(P<0.01).Correlation analysis revealed significant correlation between disease course of SLE(OR=4.25,95%CI 1.79~10.01,P<0.001),hydroxychloroquine(OR=0.26,95%CI 0.12~0.59,P<0.001)and cancer risk.Long disease course may be a risk factor for SLE patients to develop cancer,whereas hydroxychloroquine could be a protective factor.