KLINIČKA OBILJEŽJA MALIGNOMA U BOLESNIKA SA SISTEMSKIM ERITEMSKIM LUPUSOM: DESETOGODIŠNJI PODATCI IZ KLINIČKOGA BOLNIČKOG CENTRA SPLIT

Antonija Vuković, Dijana Perković, Marin Petrić, Daniela Marasović Krstulović, Mislav Radić, Dušanka Martinović Kaliterna

Objectives: Th e aim of this study was to determine the clinical features of malignant neoplasms in patients with systemic lupus erythemtosus (SLE) treated at the University Hospital Split Methods: All of the patients included in this study were suffering from SLE and were treated at the University
Hospital Split during the period from January 1, 2007 to December 31, 2016. The data were collected from the archives of the Department of Clinical Immunology and Rheumatology.
Results: In a group of 271 patients, 24 developed a malignant neoplasm (8.85%), 3 of whom were male (12.50%) and 21 female (87.50%).We found 27 malignant neoplasms due to the fact that some patients had had more than one tumor. The patients suffering from SLE and malignant neoplasms were statistically significantly older than the patients suffering only from SLE (T=3.43; p<0.001). Most patients developed malignoma after the diagnosis of SLE (79.17%). The most common malignoma localization was the cervix (25%), followed by the thyroid gland (12.50 %), lungs (8.33%), colon (8.33 %), and breast (8.33 %). According to the patohistological findings most of the patients had cancer (83.33%; p<0.001). Most of the patients in the malignoma group were ANA[ antinuclear antibody] (79.17%) and ENA [extractable nuclear antibody] (79.17%) positive. Th e majority of them were on glucocorticoid therapy (54.16%), followed by a combination of glucocorticoid and immunosuppressive therapy (29.16%).
Conclusion: Malignant diseases most commonly occur in eldery patients with SLE. In our study, the cervix was the most common localization of the malignoma. That differsfrom other studies, in which non-Hodgkin lymphoma was the most common finding. Most of the patients with malignoma and SLE were ANA and ENA positive.

Cilj istraživanja: Cilj istraživanja bio je utvrditi klinička obilježja malignih bolesti u bolesnika sa sistemskim eritemskim lupusom (SLE) liječenih u Kliničkome bolničkom centru (KBC) Split.                                                                                                                                                                                          Materijal i metode: U istraživanje su uključeni bolesnici sa SLE-om koji su liječeni u KBC-u Split u razdoblju od 1. siječnja 2007. do 31. prosinca 2016. godine. Podatci su prikupljani restrospektivno, pretraživanjem medicinske dokumentacije. Rezultati: Od 271 bolesnika maligni su tumor imala 24 (8,85%) bolesnika od kojih su 3 bila muškog spola (12,50%), a 21 ženskog spola (87,50%). Ukupno je zabilježeno 27 malignih tumora jer su neki bolesnici imali više od jednog tumora. Tri bolesnika (12,50%) sa SLE-om i malignomom bila su muškarci, a 21 su bile žene (87,50%). Bolesnici sa SLE-om i malignomom bili su znatno stariji od bolesnika koji boluju samo od SLE-a (t = 3,43; p < 0,001). Većina bolesnika (79,17%) oboljela je od malignog tumora nakon postavljanja dijagnoze SLE-a. Najčešće sijelo maligne bolesti bilo je grlo maternice (25%), zatim štitnjača (12,50%), pluća (8,33%), debelo crijevo (8,33%) i dojka (8,33%). Prema patohistološkom nalazu, najveći broj bolesnika imao je karcinom (83,33%; p < 0,001). Većina bolesnika s malignom bolesti bila je pozitivna na  ANA [antinuclear antibody] (79,17%) i ENA [extractable nuclear antibody] (79,17%). Bolesnici s malignomom najčešće su bili na terapiji glukokortikoidima (54,16%) te kombinaciji glukokortikoida i imunosupresiva (29,16%).                                                                                                                                                                                    Zaključak: Maligne bolesti javljaju se u starijih bolesnika sa SLE-om. Prema rezultatima našeg istraživanja, najčešća lokalizacija maligne bolesti jest grlo maternice iako se u literaturi najčešće spominje ne-Hodgkinov limfom. Većina bolesnika s malignomom i SLE-om bila je pozitivna na ANA i ENA.