摘要

        目的：类风湿关节炎(RA)患者发生淋巴瘤的风险增加。目前尚无预测RA发生淋巴瘤风险的生物标志物，与RA发生风险相关的指标是否也增加淋巴瘤的发生风险尚不清楚。本研究的目的在于探讨抗环瓜氨酸多肽(CCP)抗体，其他自身抗体，和吸烟与淋巴瘤发生的相关性。

        方法：从两项基于人群的病例对照研究，Scandinavian 淋巴瘤病因(SCALE) 研究和类风湿关节炎流行病学调查(EIRA)研究，我们确定淋巴瘤合并RA的患者 (n=50)，与研究中其他患者进行比较，包括非淋巴瘤的RA(n=261)，和非RA的淋巴瘤 (n=257)，和非RA非淋巴瘤患者(n=233)。淋巴瘤分型依据WHO分类标准。对血标本进行如下指标检测，包括免疫球蛋白G(IgG), IgM, 和 IgA，IgG1-4型抗CCP抗体，和15种抗核抗体 (ANA)-相关的特异性自身抗体。应用回归分析评价评估总比值比和校正后比值比(adjOR) 以及95%可信区间。

        结果：未发现抗CCP抗体 IgG≥25U/mL (adjOR 1.4, 95% CI 0.7-2.7), 抗CCP抗体 IgG≥500U/mL (adjOR1.4, 95% CI 0.7-3.0), 抗CCP抗体其他亚型，其他自身抗体 (adjOR0.6, 95% CI 0.3-1.2),或吸烟(adjOR 1.1,95% CI 0.5-2.2) 与RA患者发生淋巴瘤的风险相关。

        结论：本研究结果显示，抗CCP抗体(IgG, IgG1-4, IgM, 或IgA)、其他常见抗体或吸烟与RA发生淋巴瘤的风险无相关性。

        附原文：

        OBJECTIVES:Patients withrheumatoid arthritis(RA) are at increased risk of lymphoma. There is no biomarker to indicate future lymphoma risk in RA and it is not known whether factors associated with an increased risk of RA also confer an increased risk of lymphoma. We investigated whether anti-cyclic citrullinated peptide (CCP) antibodies, other autoantibodies, and smoking, are associated with lymphoma development in RA.

        METHOD:From two population-based case-control studies, the Scandinavian Lymphoma Etiology (SCALE) study and the Epidemiological Investigation ofRheumatoid Arthritis(EIRA)I study, we identified lymphoma cases with a validated RA diagnosis (n=50), to whom we matched study participants with RA but no lymphoma (n=261), lymphoma but no RA (n=257), and neither RA nor lymphoma (n=233). Lymphomas were classified according to the WHO classification. Blood samples were analysed for immunoglobulin G (IgG), IgM, and IgA isotypes and IgG1-4subclasses of anti-CCP antibodies and for 15 antinuclear antibody (ANA)-associated specific autoantibodies. Relative risks were estimated as crude and adjusted odds ratios (adjOR) with 95% confidence intervals (CIs) using logistic regression.RESULTS:We found no association between anti-CCP IgG≥25units/mL (adjOR 1.4, 95% CI 0.7-2.7), anti-CCP IgG≥500units/mL (adjOR 1.4, 95% CI 0.7-3.0), anti-CCP Ig of other isotypes, other autoantibodies (adjOR any vs none 0.6, 95% CI 0.3-1.2), or cigarette smoking (adjOR ever vs never 1.1, 95% CI 0.5-2.2) and lymphoma risk among patients with RA.

        CONCLUSION:In this study, neither anti-CCP antibodies (IgG, IgG1-4, IgM, or IgA), nor other common autoantibodies, nor smoking predicted lymphoma risk in RA.

        引自：Baecklund E,Backlin C,Rönnelid J, et al. Anti-cyclic citrullinated peptide antibodies, other common autoantibodies, and smoking as risk factors for lymphoma inpatients withrheumatoid arthritis.Scand JRheumatol.2018 Jan 16:1-6. doi: 10.1080/03009742.2017.1376108.[Epub ahead of print]