Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival
Background: A higher rate of cancer in systemic sclerosis (SSc) is recognized but the role of SSc-linked autoantibodies status (positive/negative and autoantibody specificities) in the survival of SSc-patients with cancer remains poorly understood. Methods: We utilized the Clalit-Health-Services med...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-06-01
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| Series: | OncoImmunology |
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| Online Access: | http://dx.doi.org/10.1080/2162402X.2019.1588084 |
| _version_ | 1818434555737014272 |
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| author | Abdulla Watad Dennis McGonagle Nicola L. Bragazzi Shmuel Tiosano Doron Comaneshter Yehuda Shoenfeld Arnon D. Cohen Howard Amital |
| author_facet | Abdulla Watad Dennis McGonagle Nicola L. Bragazzi Shmuel Tiosano Doron Comaneshter Yehuda Shoenfeld Arnon D. Cohen Howard Amital |
| author_sort | Abdulla Watad |
| collection | DOAJ |
| description | Background: A higher rate of cancer in systemic sclerosis (SSc) is recognized but the role of SSc-linked autoantibodies status (positive/negative and autoantibody specificities) in the survival of SSc-patients with cancer remains poorly understood. Methods: We utilized the Clalit-Health-Services medical database in a case-control study to evaluate the autoantibody status and specificities of SSc-patients with age- and sex-matched controls with regard to the prevalence of different cancer-subtypes and their impact on mortality. SSc-linked autoantibodies (ANA, anti-centromere, anti-RNP, anti-RNA polymerase III (RNAPIII) and anti-Scl-70) status was assessed in terms of cancer risk and outcome. Results: 2,431 SSc-patients and 12,377 age- and sex-matched controls were included. SSc-patients had a relative risk of cancer of 1.90 (95%CI 1.62-2.24, p < 0.0001) and tended to develop malignancies earlier than controls. RNAPIII and Scl-70 autoantibody were associated with an increased overall cancer risk and after SSc diagnosis risk of cancer, respectively. As expected, SSc-patients with cancer had a risk of death of 2.15 (1.65-2.79) in comparison to SSc-patients without cancer. ANA-positive SSc-patients with cancer had a better prognosis than ANA-negative cases (p = 0.0001). Despite the benefit of ANA-positive status on survival, the anti-Scl-70-positive subgroup with cancer had a significant negative impact on the survival compared to Scl-70-positive cases without cancer, whereas anti-RNAPIII and anti-centromere had no significant impact. Conclusion: ANA positivity is an independent predictor of favorable prognosis in SSc-patients with cancer, possibly suggesting that humoral autoimmunity in SSc with cancer may have some benefit. However, no survival benefit was discernible with the common autoantibodies. |
| first_indexed | 2024-12-14T16:38:51Z |
| format | Article |
| id | doaj.art-89c220b7fc9942d7961e0516d7aa1245 |
| institution | Directory Open Access Journal |
| issn | 2162-402X |
| language | English |
| last_indexed | 2024-12-14T16:38:51Z |
| publishDate | 2019-06-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | OncoImmunology |
| spelling | doaj.art-89c220b7fc9942d7961e0516d7aa12452022-12-21T22:54:22ZengTaylor & Francis GroupOncoImmunology2162-402X2019-06-018610.1080/2162402X.2019.15880841588084Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survivalAbdulla Watad0Dennis McGonagle1Nicola L. Bragazzi2Shmuel Tiosano3Doron Comaneshter4Yehuda Shoenfeld5Arnon D. Cohen6Howard Amital7The Zabludowicz Center for Autoimmune Diseases, Sheba Medical CenterUniversity of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton HospitalUniversity of GenoaThe Zabludowicz Center for Autoimmune Diseases, Sheba Medical CenterClalit Health Services Tel AvivThe Zabludowicz Center for Autoimmune Diseases, Sheba Medical CenterClalit Health Services Tel AvivThe Zabludowicz Center for Autoimmune Diseases, Sheba Medical CenterBackground: A higher rate of cancer in systemic sclerosis (SSc) is recognized but the role of SSc-linked autoantibodies status (positive/negative and autoantibody specificities) in the survival of SSc-patients with cancer remains poorly understood. Methods: We utilized the Clalit-Health-Services medical database in a case-control study to evaluate the autoantibody status and specificities of SSc-patients with age- and sex-matched controls with regard to the prevalence of different cancer-subtypes and their impact on mortality. SSc-linked autoantibodies (ANA, anti-centromere, anti-RNP, anti-RNA polymerase III (RNAPIII) and anti-Scl-70) status was assessed in terms of cancer risk and outcome. Results: 2,431 SSc-patients and 12,377 age- and sex-matched controls were included. SSc-patients had a relative risk of cancer of 1.90 (95%CI 1.62-2.24, p < 0.0001) and tended to develop malignancies earlier than controls. RNAPIII and Scl-70 autoantibody were associated with an increased overall cancer risk and after SSc diagnosis risk of cancer, respectively. As expected, SSc-patients with cancer had a risk of death of 2.15 (1.65-2.79) in comparison to SSc-patients without cancer. ANA-positive SSc-patients with cancer had a better prognosis than ANA-negative cases (p = 0.0001). Despite the benefit of ANA-positive status on survival, the anti-Scl-70-positive subgroup with cancer had a significant negative impact on the survival compared to Scl-70-positive cases without cancer, whereas anti-RNAPIII and anti-centromere had no significant impact. Conclusion: ANA positivity is an independent predictor of favorable prognosis in SSc-patients with cancer, possibly suggesting that humoral autoimmunity in SSc with cancer may have some benefit. However, no survival benefit was discernible with the common autoantibodies.http://dx.doi.org/10.1080/2162402X.2019.1588084systemic sclerosissclerodermamalignancycancerautoantibodiesautoimmune diseases |
| spellingShingle | Abdulla Watad Dennis McGonagle Nicola L. Bragazzi Shmuel Tiosano Doron Comaneshter Yehuda Shoenfeld Arnon D. Cohen Howard Amital Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival OncoImmunology systemic sclerosis scleroderma malignancy cancer autoantibodies autoimmune diseases |
| title | Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival |
| title_full | Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival |
| title_fullStr | Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival |
| title_full_unstemmed | Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival |
| title_short | Autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ANA negativity in cases with concomitant cancer having a worse survival |
| title_sort | autoantibody status in systemic sclerosis patients defines both cancer risk and survival with ana negativity in cases with concomitant cancer having a worse survival |
| topic | systemic sclerosis scleroderma malignancy cancer autoantibodies autoimmune diseases |
| url | http://dx.doi.org/10.1080/2162402X.2019.1588084 |
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