Predictable biomarkers of developing lymphoma in patients with Sjögren syndrome: a nationwide population-based cohort study.
Sjögren syndrome (SS) is commonly known to be correlated with lymphoma. This study included 16,396 individuals in the SS cohort and 65,584 individuals in the non-SS cohort, all of whom were enrolled in the Taiwan National Health Insurance database between 2000 and 2010. We evaluated the risk factors of non-Hodgkin's lymphoma (NHL) in the primary SS cohort by applying a Cox multivariable proportional-hazards model. We increased the correlation of patients with SS and NHL, with an adjusted HR of 4.314 (95% CI 2.784 - 6.685). Of the 16,396 SS patients, 66 individuals had salivary gland slices without NHL development, while the other 16,330 individuals that did not have salivary gland slices revealed 30 individuals that developed NHL. Of the 16,396 SS patients, 128 individuals underwent immunomodulator agent therapy (including hydroxychloroquine, azathioprine, cyclosporine, methotrexate, and rituximab) without NHL development. None of the 30 individuals that developed NHL from SS received immunomodulator agents. We found that patients with SS were at an increased risk of developing NHL, with the most common NHL subgroup being diffused large B-cell lymphoma. SS patients who were candidates for salivary gland slices or immunomodulator agents were associated with a lower risk of developing lymphoma over time. We recommend that patients at a higher risk upon diagnosis of SS receive close follow-up and aggressive treatment.
Department of Internal Medicine, Division of Rheumatology/Immunology/Allergies, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Yu-Hsiang
YH
Chiu
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Chi-Hsiang
CH
Chung
Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Kuen-Tze
KT
Lin
Department of Internal Medicine, Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chin-Sheng
CS
Lin
Department of Internal Medicine, Division of Hematology/Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Jia-Hong
JH
Chen
Department of Internal Medicine, Division of Rheumatology/Immunology/Allergies, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Hsiang-Cheng
HC
Chen
Department of Periodontology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Ren-Yeong
RY
Huang
Department of Oral and Maxillofacial Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chi-Tsung
CT
Wu
Department of Internal Medicine, Division of Rheumatology/Immunology/Allergies, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Feng-Cheng
FC
Liu
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Wu-Chien
WC
Chien
D015415:Biomarkers / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012859:Sjogren's Syndrome / Q000150:complications* / Q000473:pathology
D015415:Biomarkers
Sjögren syndrome; diffuse large B-cell lymphoma; immunosuppressive agents; lip biopsy; non-Hodgkin’s lymphoma