Rheumatology advances in practice · 2025
Evaluation of malignancy risk in patients with SSc by autoantibody profile: a systematic review with meta-analysis.
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Towachiraporn Kamonwan, Sanyanusin Woramate, Rojhirunsakool Salinee, Smith Gideon P, Lertphanichkul Chotinij
Аннотация
OBJECTIVE: Increased risk of cancer has been reported in SSc patients; however, the magnitude of this risk seems to vary with SSc-specific autoantibody profile. We aimed to review cancer risk in SSc patients by autoantibody subtypes.
METHODS: We systematically reviewed literature related to cancer in SSc patients from January 1980 to December 2023 using PubMed, Embase, Scopus, and Cochrane Library. We performed a meta-analysis comparing cancer risk in SSc patients with ACA, anti-RNAP III antibody, and anti-Scl70 antibody. The search was conducted on 1 December 2023 and updated on 30 December 2023. Eligible studies were required to (1) include participants ≥18 years who fulfilled the 2013 ACR/EULAR, 1980 ACR modified, or LeRoy and Medsger classification criteria, (2) report cancer incidence with SSc-specific autoantibody, and (3) analyse the relationship between SSc-specific autoantibodies and cancer.
RESULTS: Twenty-two eligible studies were included and underwent meta-analysis. Anti-RNAP III positivity was associated with a significantly increased cancer risk in SSc patients (pooled relative risk (RR) 1.48; 95% CI 1.16-1.80), compared with anti-RNAP III-negative patients. While the presence of ACA was associated with a lower cancer risk (pooled RR 0.78; 95% CI 0.60-0.96) and may serve as an indicator for solely SSc, specifically limited systemic scleroderma.
CONCLUSION: Our meta-analysis showed that anti-RNAP III-positive SSc patients had a 48% higher risk of developing cancer compared with anti-RNAP III-negative SSc patients. Therefore, physicians should be aware of this elevated risk. Rigorous screening for malignancy by age-appropriate and relevant family history is recommended.
METHODS: We systematically reviewed literature related to cancer in SSc patients from January 1980 to December 2023 using PubMed, Embase, Scopus, and Cochrane Library. We performed a meta-analysis comparing cancer risk in SSc patients with ACA, anti-RNAP III antibody, and anti-Scl70 antibody. The search was conducted on 1 December 2023 and updated on 30 December 2023. Eligible studies were required to (1) include participants ≥18 years who fulfilled the 2013 ACR/EULAR, 1980 ACR modified, or LeRoy and Medsger classification criteria, (2) report cancer incidence with SSc-specific autoantibody, and (3) analyse the relationship between SSc-specific autoantibodies and cancer.
RESULTS: Twenty-two eligible studies were included and underwent meta-analysis. Anti-RNAP III positivity was associated with a significantly increased cancer risk in SSc patients (pooled relative risk (RR) 1.48; 95% CI 1.16-1.80), compared with anti-RNAP III-negative patients. While the presence of ACA was associated with a lower cancer risk (pooled RR 0.78; 95% CI 0.60-0.96) and may serve as an indicator for solely SSc, specifically limited systemic scleroderma.
CONCLUSION: Our meta-analysis showed that anti-RNAP III-positive SSc patients had a 48% higher risk of developing cancer compared with anti-RNAP III-negative SSc patients. Therefore, physicians should be aware of this elevated risk. Rigorous screening for malignancy by age-appropriate and relevant family history is recommended.