Περίληψη:
The heightened risk of non-Hodgkin lymphoma (NHL) development in primary Sjogren syndrome (SS) is well established. Several adverse clinical and laboratory predictors have been described. In the current work, we aimed to formulate a predictive score for NHL development, based on clinical, serological, and histopathological findings at the time of SS diagnosis. In the present case-control study of 381 primary SS patients and 92 primary SS patients with concomitant NHL, clinical, serological, and histopathological variables at the time of SS diagnosis were retrospectively recorded. For the identification of predictors for NHL development univariate and multivariate models were constructed. Salivary gland enlargement (SGE), lymphadenopathy, Raynaud phenomenon, anti-Ro/SSA or/and anti-La/SSB autoantibodies, rheumatoid factor (RF) positivity, monoclonal gammopathy, and C4 hypocomplementemia were shown to be independent predictors for NHL development. On the basis of the number of independent risk factors identified, a predictive risk score for NHL development was formulated. Thus, patients presenting with ≤2 risk factors had a 3.8% probability of NHL development, those with 3 to 6 risk factors 39.9% (OR (95%CI): 16.6 [6.5-42.5], P<0.05), while in the presence of all 7 risk factors the corresponding probability reached 100% (OR [95%CI]: 210.0 [10.0-4412.9], P<0.0001). In conclusion, an easy to use diagnostic scoring tool for NHL development in the context of SS is presented. This model is highly significant for the design of early therapeutic interventions in high risk SS patients for NHL development. © 2016 Wolters Kluwer Health, Inc.
Συγγραφείς:
Fragkioudaki, S.
Mavragani, C.P.
Moutsopoulos, H.M.
Λέξεις-κλειδιά:
complement component C4; La antibody; rheumatoid factor; Ro antibody; autoantibody, adult; Article; cancer risk; case control study; cryoglobulinemia; female; histopathology; human; hypocomplementemia; lymphadenopathy; major clinical study; male; model; monoclonal immunoglobulinemia; nonhodgkin lymphoma; prevalence; priority journal; Raynaud phenomenon; retrospective study; risk assessment; salivary gland; scoring system; serology; Sjoegren syndrome; biopsy; complication; Greece; incidence; lacrimal apparatus; lymph node; Lymphoma, Non-Hodgkin; metabolism; middle aged; minor saliva gland; pathology; risk assessment; risk factor; Sjogren's Syndrome, Adult; Autoantibodies; Biopsy; Female; Greece; Humans; Incidence; Lacrimal Apparatus; Lymph Nodes; Lymphoma, Non-Hodgkin; Male; Middle Aged; Retrospective Studies; Risk Assessment; Risk Factors; Salivary Glands, Minor; Sjogren's Syndrome
