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Examination of autoantibody status and clinical features associated with cancer risk and cancer-associated scleroderma.

AbstractOBJECTIVE:
We previously reported a contemporaneous onset of cancer and scleroderma in patients with anti-RNA polymerase III antibodies, and we identified a biologic link between cancer and scleroderma. This investigation was designed to further evaluate whether autoantibody status and other characteristics are associated with cancer and a clustering of cancer with scleroderma onset.
METHODS:
Logistic regression analysis was performed to assess the relationship of 2 outcomes, cancer (model 1) and a short (±2 years) cancer-scleroderma interval (model 2), with autoantibody status and scleroderma covariates.
RESULTS:
Of 1,044 scleroderma patients, 168 (16.1%) had cancer. In the adjusted model 1, only older age at scleroderma onset (odds ratio 1.04 [95% confidence interval 1.02-1.05]) and white race (odds ratio 2.71 [95% confidence interval 1.22-6.04]) were significantly associated with an increased overall risk of cancer. In the adjusted model 2, only anti-RNA polymerase III positivity (odds ratio 5.08 [95% confidence interval 1.60-16.1]) and older age at scleroderma onset (odds ratio 1.04 [95% confidence interval 1.00-1.08]) were significantly associated with a short cancer-scleroderma interval. While anti-RNA polymerase III positivity was associated with a short cancer-scleroderma interval independent of age at scleroderma onset, the cancer-scleroderma interval shortened with older age at scleroderma onset in other antibody groups (Spearman's correlation P < 0.05), particularly among patients with anti-topoisomerase I antibodies and patients who were negative for anticentromere, anti-topoisomerase I, and anti-RNA polymerase III antibodies.
CONCLUSION:
Increased age at scleroderma onset is strongly associated with cancer risk overall. While anti-RNA polymerase III status is an independent marker of coincident cancer and scleroderma at any age, a clustering of cancer with scleroderma is also seen in patients with anti-topoisomerase I and other autoantibody specificities who develop scleroderma at older ages.
AuthorsAmi A Shah, Laura K Hummers, Livia Casciola-Rosen, Kala Visvanathan, Antony Rosen, Fredrick M Wigley
JournalArthritis & rheumatology (Hoboken, N.J.) (Arthritis Rheumatol) Vol. 67 Issue 4 Pg. 1053-61 (Apr 2015) ISSN: 2326-5205 [Electronic] United States
PMID25605296 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2015 by the American College of Rheumatology.
Chemical References
  • Autoantibodies
  • RNA Polymerase III
Topics
  • Adult
  • Aged
  • Autoantibodies (blood)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms (blood, complications, immunology)
  • RNA Polymerase III (immunology)
  • Risk Factors
  • Scleroderma, Systemic (blood, complications, immunology)

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