目 的：

        探索风湿性多肌痛(PMR)患者中肿瘤的发生率。

        方 法：

        收集英国实践研究数据库中的风湿性多肌痛患者2877人，除外曾诊断肿瘤、血管病的患者，患者均接受糖皮质激素治疗。选用年龄、性别匹配的患者9942人;随访终点：第一次癌症诊断、死亡、移出数据库或记录结束。

        结 果：

        这些PMR患者的平均年龄71.6岁，73%为女性患者。随访中位年龄是7.8年。23.2%的PMR患者发生了肿瘤，高于对照组的19.5%。在PMR诊断的6个月内，PMR患者发生肿瘤的风险是1.69倍(1.18-2.24)。PMR诊断的6月内，虽肿瘤发生率不高，但下述肿瘤更常见：前列腺、血液、淋巴结、妇科、神经系统等部位。

        结 论：

        研究显示在PMR诊断的6个月内肿瘤发生率较高。临床医师在诊断PMR时应充分的筛查肿瘤，对可能是肿瘤的患者进行严密监测。

        原 文

        Iscancerassociatedwithpolymyalgia rheumatica? Acohort studyin theGeneral PracticeResearchDatabase.

        Abstract

        OBJECTIVE:

        To investigate the incidence of newcancerdiagnoses in a community sample of patients withpolymyalgia rheumatica(PMR).

        METHODS:

        All incident cases of PMR in the UKGeneral PracticeResearchDatabase(GPRD) (1987-99), without pre-existingcanceror vascular disease and treated with corticosteroids (n=2877) were matched with up to five age, sex and GPpracticepatients without PMR (n=9942). Participants were followed up until firstcancerdiagnosis, death, transfer out of thedatabaseor end of available records.

        RESULTS:

        The mean age of the sample was 71.6years (SD 9.0), 73% were female. Median follow-up time was 7.8years (IQR 3.4, 12.3). 667 (23.2%) people with a PMR diagnosis developedcancercompared with 1938 (19.5%) of those without PMR. There was an interaction between PMR status and time. In the first 6months after diagnosis, those with a PMR diagnosis were significantly more likely to receive acancerdiagnosis (adjusted HR (95% CI): 1.69 (1.18 to 2.42)). The number of events was small, but occurrences of prostate, blood, lymph nodes, female reproductive and nervous systemcancersmay be more common in those with PMR in the first 6months after PMR diagnosis.

        CONCLUSIONS:

        An increase in the rate ofcancerdiagnoses was noted in the first 6months of observation, but we were unable to determine whether thecancerincidence in PMR was different from controls, beyond this time point. Clinicians should ensure they fully excludecanceras a cause of PMR-like symptoms and monitor patients for possible malignancies.

        文献：Ann Rheum Dis.2014Oct;73(10):1769-73. doi: 10.1136/annrheumdis-2013-203465. Epub 2013 Jul 10.