Analysis of clinical characteristics and related factors of rheumatoid arthritis complicated with malignant tumors in patients

doi:10.3969/j.issn.1004-583X.2021.03.012

Abstract

Abstract:

Objective To investigate the clinical characteristics and related factors of rheumatoid arthritis(RA) complicated with malignant tumor inpatients. Methods Clinical data of patients with RA complicated with malignant tumor admitted to the Affiliated Hospital of Qingdao University from February 2013 to August 2019 were retrospectively analyzed. Complete clinical data of a total of 217 patients with RA complicated with malignant tumors were collected(tumor group), and 308 patients with RA but without tumors during the same period were randomly selected as controls(control group). Results The number of women/men, RA duration, and smokers in tumor group were higher than those in control group(P<0.05), while the utilization rate of steroid hormone and traditional anti-rheumatic drugs in tumor group was lower than that in control group(P<0.05). The course of RA, smoking history and gender difference were the independent risk factors of RA complicated with malignant tumor(P<0.05), while the treatment history of methotrexate or leflunomide was the independent protective factor(P<0.05). Conclusion RA patients have an increased risk of malignancy. RA patients with long course of disease, females and smoking history should be alert to the possibility of cancer. Methotrexate or leflunomide can reduce the risk of cancer.

Key words: arthritis, rheumatoid, neoplasms, antirheumatic agents

CLC Number:

R593.22

Liu Ziyi, Wang Jibo. Analysis of clinical characteristics and related factors of rheumatoid arthritis complicated with malignant tumors in patients[J]. Clinical Focus, 2021, 36(3): 246-250.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.03.012

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I3/246

Figures/Tables 4

References 19

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肿瘤类型	例数	男/女 (例)	肿瘤先发/ 同年发生/ RA先发(例)	RA发病年龄 (岁)	肿瘤确诊年龄 (岁)	吸烟史 (例)	肿瘤家族史 (例)	类固醇激素 (例)	甲氨蝶呤 (例)	来氟米特 (例)	生物制剂 (例)
肺癌	43	23/20	1/1/41	53.1±11.8	65.3±7.7	23	9	25	18	21	3
甲状腺癌	30	3/27	3/0/27	46.3±12.9	58.7±11.2	2	7	11	15	8	2
乳腺癌	23	0/23	5/0/18	49.7±10.8	60.5±10.2	0	7	7	10	10	1
淋巴瘤	17	6/11	0/3/14	50.5±15.3	59.0±10.8	4	6	11	9	8	1
胃癌	15	9/6	3/0/12	51.2±12.0	60.7±11.2	7	4	6	6	3	0
直肠癌	14	5/9	1/0/13	43.5±16.2	67.2±10.6	5	5	6	4	6	1
结肠癌	12	4/8	2/0/10	55.4±14.5	68.3±9.4	3	0	5	4	4	0
肝癌	9	5/4	1/0/8	42.8±14.5	58.9±10.6	3	2	2	2	2	1
子宫颈癌	8	0/8	0/0/8	44.4±13.0	59.8±6.9	0	5	3	2	3	0
胆囊及胆管癌	7	3/4	0/0/7	56.0±13.4	72.9±7.1	3	0	2	3	2	0
膀胱癌	7	3/4	0/0/7	45.0±14.3	66.3±10.4	2	1	3	4	2	0
喉癌	6	5/1	0/0/6	51.3±8.1	65.5±8.3	5	0	2	3	2	0
前列腺癌	5	5/0	0/0/5	60.2±11.5	76.6±7.7	5	1	3	2	2	1
胰腺癌	5	1/4	0/0/5	46.6±7.1	63.8±5.6	1	2	1	3	1	1
肾癌	4	1/3	0/0/4	47.0±7.6	62.5±7.5	1	0	0	1	0	0
子宫内膜癌	4	0/4	0/0/4	49.3±18.9	59.5±13.1	0	2	2	1	3	0
卵巢癌	3	0/3	0/0/3	45.7±6.1	60.7±3.1	0	0	2	1	2	0
食管癌	3	2/1	0/0/3	48.3±6.5	69.3±6.9	2	1	0	1	1	0
鼻咽癌	2	1/1	0/0/2	47.5±4.5	67.5±11.5	1	0	1	1	1	0
总计	217	76/141	16/4/197	49.6±13.4	63.2±10.5	67	52	92	90	81	11

肿瘤类型	例数	男/女 (例)	肿瘤先发/ 同年发生/ RA先发(例)	RA发病年龄 (岁)	肿瘤确诊年龄 (岁)	吸烟史 (例)	肿瘤家族史 (例)	类固醇激素 (例)	甲氨蝶呤 (例)	来氟米特 (例)	生物制剂 (例)
肺癌	43	23/20	1/1/41	53.1±11.8	65.3±7.7	23	9	25	18	21	3
甲状腺癌	30	3/27	3/0/27	46.3±12.9	58.7±11.2	2	7	11	15	8	2
乳腺癌	23	0/23	5/0/18	49.7±10.8	60.5±10.2	0	7	7	10	10	1
淋巴瘤	17	6/11	0/3/14	50.5±15.3	59.0±10.8	4	6	11	9	8	1
胃癌	15	9/6	3/0/12	51.2±12.0	60.7±11.2	7	4	6	6	3	0
直肠癌	14	5/9	1/0/13	43.5±16.2	67.2±10.6	5	5	6	4	6	1
结肠癌	12	4/8	2/0/10	55.4±14.5	68.3±9.4	3	0	5	4	4	0
肝癌	9	5/4	1/0/8	42.8±14.5	58.9±10.6	3	2	2	2	2	1
子宫颈癌	8	0/8	0/0/8	44.4±13.0	59.8±6.9	0	5	3	2	3	0
胆囊及胆管癌	7	3/4	0/0/7	56.0±13.4	72.9±7.1	3	0	2	3	2	0
膀胱癌	7	3/4	0/0/7	45.0±14.3	66.3±10.4	2	1	3	4	2	0
喉癌	6	5/1	0/0/6	51.3±8.1	65.5±8.3	5	0	2	3	2	0
前列腺癌	5	5/0	0/0/5	60.2±11.5	76.6±7.7	5	1	3	2	2	1
胰腺癌	5	1/4	0/0/5	46.6±7.1	63.8±5.6	1	2	1	3	1	1
肾癌	4	1/3	0/0/4	47.0±7.6	62.5±7.5	1	0	0	1	0	0
子宫内膜癌	4	0/4	0/0/4	49.3±18.9	59.5±13.1	0	2	2	1	3	0
卵巢癌	3	0/3	0/0/3	45.7±6.1	60.7±3.1	0	0	2	1	2	0
食管癌	3	2/1	0/0/3	48.3±6.5	69.3±6.9	2	1	0	1	1	0
鼻咽癌	2	1/1	0/0/2	47.5±4.5	67.5±11.5	1	0	1	1	1	0
总计	217	76/141	16/4/197	49.6±13.4	63.2±10.5	67	52	92	90	81	11

组别		例数		性别(例)		RA确诊年龄 (岁)		RA病程 (年)		CRP (mg/L)		ESR (mm/h)		ACPA阳性 (例)		RF阳性 (例)		使用类固醇激素(例)		使用甲氨蝶呤(例)
组别		例数		男	女	RA确诊年龄 (岁)		RA病程 (年)		CRP (mg/L)		ESR (mm/h)		ACPA阳性 (例)		RF阳性 (例)		使用类固醇激素(例)		使用甲氨蝶呤(例)
RA合并肿瘤组		197		71	126	48.51±13.10		15.20±11.25		11.15±12.46		24.51±18.29		165		158		83		79
RA无肿瘤组		308		62	246	49.36±13.57		7.54±5.54		10.10±10.82		25.76±18.07		259		240		173		213
统计值				χ²=15.678		t=0.693		t=-8.864		t=-0.971		t=0.752		χ²=0.010		χ²=0.374		χ²=9.471		χ²=41.588
P值				<0.05		>0.05		<0.05		>0.05		>0.05		>0.05		>0.05		<0.05		<0.05
组别	例数		使用来氟米特 (例)			使用非甾体抗炎药(例)	使用生物制剂 (例)		吸烟史 (例)		贫血 (例)		肺间质病变 (例)		肿瘤家族史 (例)		关节畸形 (例)		类风湿结节 (例)
RA合并肿瘤组	197		79			36	11		64		10		9		47		31		18
RA无肿瘤组	308		213			77	17		25		7		15		55		38		24
统计值			χ²=11.473			χ²=3.129	χ²=0.001		χ²=49.153		χ²=2.903		χ²=0.024		χ²=2.684		χ²=1.176		χ²=0.285
P值			<0.05			>0.05	>0.05		<0.05		>0.05		>0.05		>0.05		>0.05		>0.05

组别		例数		性别(例)		RA确诊年龄 (岁)		RA病程 (年)		CRP (mg/L)		ESR (mm/h)		ACPA阳性 (例)		RF阳性 (例)		使用类固醇激素(例)		使用甲氨蝶呤(例)
组别		例数		男	女	RA确诊年龄 (岁)		RA病程 (年)		CRP (mg/L)		ESR (mm/h)		ACPA阳性 (例)		RF阳性 (例)		使用类固醇激素(例)		使用甲氨蝶呤(例)
RA合并肿瘤组		197		71	126	48.51±13.10		15.20±11.25		11.15±12.46		24.51±18.29		165		158		83		79
RA无肿瘤组		308		62	246	49.36±13.57		7.54±5.54		10.10±10.82		25.76±18.07		259		240		173		213
统计值				χ²=15.678		t=0.693		t=-8.864		t=-0.971		t=0.752		χ²=0.010		χ²=0.374		χ²=9.471		χ²=41.588
P值				<0.05		>0.05		<0.05		>0.05		>0.05		>0.05		>0.05		<0.05		<0.05
组别	例数		使用来氟米特 (例)			使用非甾体抗炎药(例)	使用生物制剂 (例)		吸烟史 (例)		贫血 (例)		肺间质病变 (例)		肿瘤家族史 (例)		关节畸形 (例)		类风湿结节 (例)
RA合并肿瘤组	197		79			36	11		64		10		9		47		31		18
RA无肿瘤组	308		213			77	17		25		7		15		55		38		24
统计值			χ²=11.473			χ²=3.129	χ²=0.001		χ²=49.153		χ²=2.903		χ²=0.024		χ²=2.684		χ²=1.176		χ²=0.285
P值			<0.05			>0.05	>0.05		<0.05		>0.05		>0.05		>0.05		>0.05		>0.05

组别	例数	CA125(U/ml)	CA153(U/ml)	CA199(U/ml)	CEA(ng/ml)
RA合并肿瘤组	101	12.76(4.15, 43.95)	12.47(3.62, 17.52)	10.05(5.10, 32.41)	2.05(0.66, 10.33)
RA无肿瘤组	70	12.95(5.95, 27.27)	13.42(6.39, 24.26)	12.63(6.79, 24.15)	2.24(0.69, 4.48)
Z值		-1.336	-1.415	-1.006	-1.282
P值		>0.05	>0.05	>0.05	>0.05