日前，一则发表在Br J Dermatol杂志上的研究"Increased risk of cancer among 3,663 patients with cutaneous lupus erythematosus- a Swedish nationwide cohort study"证明皮肤型狼疮患者患恶性肿瘤的风险增加。
多种自身免疫疾病与恶性肿瘤的发生相关，有很多病例报告提示皮肤红斑狼疮（CLE）与多种不同的恶性肿瘤相关。研究者通过全瑞典范围内对诊断CLE的患者与未诊断CLE的对照组进行队列研究，来评判CLE患者恶性肿瘤总的发生风险及其类型。
本研究共纳入3663例确诊CLE的患者，从正常人群中筛选与之匹配的对照组（对照组与病例组比例为3：1）。所有资料来源于1997-2007年间瑞士全国病人登记系统，并与瑞士全国癌症登记系统及瑞士全国死因登记系统相联网。对恶性肿瘤病例数的观测值与预测值进行风险比（HRs）及95%置信区间（CIs）的计算。在整个研究期间共有183例恶性肿瘤报告，HR为1.8（95%CI为1.5-2.2）。中位随访时间为4.1年。口腔恶性肿瘤，淋巴瘤，呼吸系统恶性肿瘤及非恶性黑色素瘤皮肤恶性肿瘤的发生风险大约为正常人群的4倍。
因此，CLE患者具有罹患某些恶性肿瘤的较高风险，除外了同时患有系统性红斑狼疮的患者，这种风险依然存在。研究强调了CLE患者戒烟、避免日晒的重要性，并且指出这些患者需要自实验室到临床的密切监测以评估其发病的病理过程。（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
