Sainan Bian1,2, Li Wang1,2, Yunyun Fei1,2, Suying Liu1,2, Hua Chen3,4, Fengchun Zhang5,6. 1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, China. 2. Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China. 3. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, China. chenhua@pumch.cn. 4. Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China. chenhua@pumch.cn. 5. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, China. zhangfccra@aliyun.com. 6. Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China. zhangfccra@aliyun.com.
Abstract
OBJECTIVES: To analyze the clinical and laboratory features of primary biliary cholangitis (PBC) patients complicated with cancer, and explore the potential factors associated with cancer. METHODS: We consecutively enrolled PBC patients from January 2002 to February 2016 in Peking Union Medical College Hospital and performed a structured interview, systemic rheumatologic evaluation, and laboratory tests. The risk factors associated with cancer were analyzed with univariate and multivariable logistic regression and proportional hazard model. RESULTS: Among the 580 PBC patients enrolled, 51 cancers were identified in 51 patients (8.8%), including 45 (88.2%) solid tumors and 6 (11.8%) hematologic malignancies. Patients with cancer were older (62.1 ± 9.6 vs. 55.4 ± 11.6 years, p < 0.01) than patients without cancer. Additionally, positive anti-centromere antibody (ACA) was more frequently observed in patients without cancer (25.9% vs 4.3%, p = 0.019) compared with patients with cancer diagnosed after establishing PBC. The median follow-up after the diagnosis of PBC was 4 years (IQR 2.0-6.6). Furthermore, multivariable logistic regression confirmed that older age was associated with cancer in PBC patients (odds ratio (OR) = 1.045, 95% confidence interval (CI): 1.006-1.085), and positive ACA was a protective factor (OR = 0.116, 95% CI: 0.015-0.876). Additionally, proportional hazard model analysis revealed that age was a risk factor (hazard ratio = 1.045, 95% CI: 1.012-1.080), and positive ACA was a protective factor (hazard ratio = 0.232, 95% CI: 0.055-0.977) for cancer. CONCLUSIONS: Both solid tumor and hematologic malignancy were prevalent in PBC patients. Older age was associated with cancer, and positive ACA was a protective factor of cancer in PBC patients. Key Points • Patients with PBC could present with both solid tumors and hematologic malignancies. • Multivariable logistic regression and proportional hazard model analysis revealed that age was a risk factor as we know, and positive ACA was a protective factor.
OBJECTIVES: To analyze the clinical and laboratory features of primary biliary cholangitis (PBC) patients complicated with cancer, and explore the potential factors associated with cancer. METHODS: We consecutively enrolled PBC patients from January 2002 to February 2016 in Peking Union Medical College Hospital and performed a structured interview, systemic rheumatologic evaluation, and laboratory tests. The risk factors associated with cancer were analyzed with univariate and multivariable logistic regression and proportional hazard model. RESULTS: Among the 580 PBC patients enrolled, 51 cancers were identified in 51 patients (8.8%), including 45 (88.2%) solid tumors and 6 (11.8%) hematologic malignancies. Patients with cancer were older (62.1 ± 9.6 vs. 55.4 ± 11.6 years, p < 0.01) than patients without cancer. Additionally, positive anti-centromere antibody (ACA) was more frequently observed in patients without cancer (25.9% vs 4.3%, p = 0.019) compared with patients with cancer diagnosed after establishing PBC. The median follow-up after the diagnosis of PBC was 4 years (IQR 2.0-6.6). Furthermore, multivariable logistic regression confirmed that older age was associated with cancer in PBC patients (odds ratio (OR) = 1.045, 95% confidence interval (CI): 1.006-1.085), and positive ACA was a protective factor (OR = 0.116, 95% CI: 0.015-0.876). Additionally, proportional hazard model analysis revealed that age was a risk factor (hazard ratio = 1.045, 95% CI: 1.012-1.080), and positive ACA was a protective factor (hazard ratio = 0.232, 95% CI: 0.055-0.977) for cancer. CONCLUSIONS: Both solid tumor and hematologic malignancy were prevalent in PBC patients. Older age was associated with cancer, and positive ACA was a protective factor of cancer in PBC patients. Key Points • Patients with PBC could present with both solid tumors and hematologic malignancies. • Multivariable logistic regression and proportional hazard model analysis revealed that age was a risk factor as we know, and positive ACA was a protective factor.
Authors: Nerea Iniesta Arandia; Carmen Pilar Simeón-Aznar; Alfredo Guillén Del Castillo; Dolores Colunga Argüelles; Manuel Rubio-Rivas; Luis Trapiella Martínez; Francisco José García Hernández; Luis Sáez Comet; María Victoria Egurbide Arberas; Norberto Ortego-Centeno; Mayka Freire; Begoña Marí Alfonso; José Antonio Vargas Hitos; Juan José Ríos Blanco; José Antonio Todolí Parra; Monica Rodríguez-Carballeira; Adela Marín Ballvé; Antonio Javier Chamorro Fernández; Xavier Pla Salas; Ana Belen Madroñero Vuelta; Manuel Ruiz Muñoz; Vicent Fonollosa Pla; Gerard Espinosa Journal: Clin Exp Rheumatol Date: 2017-09-21 Impact factor: 4.473