Rheumatology (Oxford, England) · 2026
Clinical and autoantibody associations with malignancy in systemic sclerosis: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Raghupathy Jaivikash, Teoh Wei Shan, Kanneganti Abhiram, Binte Abdul Kadir Hanis, Teng Gim Gee, Tong Pearl Shuang Ye, Host Lauren V, Morrisroe Kathleen, Nikpour Mandana, Low Andrea Hsiu Ling, Scleroderma Clinical Trials Consortium (SCTC) Cancer Working Group
Аннотация
OBJECTIVE: This meta-analysis examined factors associated with malignancy in SSc.
METHODS: A systematic search of the Embase, MEDLINE and Cochrane Library databases was conducted from inception to 7 December 2024. Case-control and cohort studies reporting associations with malignancy in SSc were included. Random-effects meta-analyses were performed to pool study results. Mean differences (MDs) for age and odds ratios (ORs) for binary outcomes using frequency counts were calculated. Study quality was assessed using Newcastle-Ottawa Scale.
RESULTS: Thirty-five studies comprising 27 624 SSc patients were analysed. Patients with malignancy developed SSc at an older age (MD +4.01, 95% CI 1.24-6.78). Significant associations for malignancy included male gender (OR 1.36), smoking (OR 1.27), pulmonary hypertension (PH, OR 1.32), interstitial lung disease (ILD; OR 1.41), dcSSc (OR 1.14), positive anti-RNAPIII (OR 1.79) and ACA (OR 0.83), and negative ANA (OR 1.39). In sensitivity analyses of high-quality studies, male gender, smoking, PH and anti-RNAPIII remained significant. Subgroup analyses by malignancy types and development in relation to SSc diagnosis revealed positive associations of lung malignancy with male gender (OR 2.72), smoking (OR 2.38), anti-topo I (OR 2.45) and ILD (OR 2.98), while ACA was inversely associated (OR 0.32). Anti-RNAPIII was associated with breast malignancy (OR 2.17) and early/concurrent malignancy (OR 2.85), and digital ulceration (OR 0.39) with later malignancy development.
CONCLUSION: Malignancy association in SSc is influenced by clinical phenotype and autoantibody profile. Our findings suggest a risk-stratified approach to malignancy surveillance rather than uniform screening.
METHODS: A systematic search of the Embase, MEDLINE and Cochrane Library databases was conducted from inception to 7 December 2024. Case-control and cohort studies reporting associations with malignancy in SSc were included. Random-effects meta-analyses were performed to pool study results. Mean differences (MDs) for age and odds ratios (ORs) for binary outcomes using frequency counts were calculated. Study quality was assessed using Newcastle-Ottawa Scale.
RESULTS: Thirty-five studies comprising 27 624 SSc patients were analysed. Patients with malignancy developed SSc at an older age (MD +4.01, 95% CI 1.24-6.78). Significant associations for malignancy included male gender (OR 1.36), smoking (OR 1.27), pulmonary hypertension (PH, OR 1.32), interstitial lung disease (ILD; OR 1.41), dcSSc (OR 1.14), positive anti-RNAPIII (OR 1.79) and ACA (OR 0.83), and negative ANA (OR 1.39). In sensitivity analyses of high-quality studies, male gender, smoking, PH and anti-RNAPIII remained significant. Subgroup analyses by malignancy types and development in relation to SSc diagnosis revealed positive associations of lung malignancy with male gender (OR 2.72), smoking (OR 2.38), anti-topo I (OR 2.45) and ILD (OR 2.98), while ACA was inversely associated (OR 0.32). Anti-RNAPIII was associated with breast malignancy (OR 2.17) and early/concurrent malignancy (OR 2.85), and digital ulceration (OR 0.39) with later malignancy development.
CONCLUSION: Malignancy association in SSc is influenced by clinical phenotype and autoantibody profile. Our findings suggest a risk-stratified approach to malignancy surveillance rather than uniform screening.