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Master Thesis

Étude des caractéristiques cliniques et immunologiques des sclérodermies systémiques associées à des cancers : étude monocentrique rétrospective sur la cohorte Bordelaise

Abstract : Objectives: several studies have reported an increased incidence of cancer in patients with systemic sclerosis (SSc). While the identification of RNA polymerase III antibody (anti- RNA POL 3) as a predictive factor has been confirmed, the identification of others risk factors is still unclear. We aim to assess clinical and immunological predictive factors of association with SSc and cancer. Methods: using a local retrospective cohort study, we compared SSc patients with and without associated malignancy. In a second step, a subgroup analysis was carried out depending on the time of cancer onset, and on the type of cancer. Results: of 464 scleroderma patients, 74 (15,9%) had cancer. Among them, breast (n=26) and lung cancer (n=13) were the most frequent. In 23 patients (31%) the diagnosis of both scleroderma and malignancy was made in less than 3 years apart. In multivariate analysis, RNA polymerase III and SSA antibodies were significantly associated with an increased overall risk of cancer with an odds ratio (OR) of 4.12 (95% IC[1.59-10.7]; p=0.004) and 2.43 (95% IC[1.09-5.39]; p=0.029), respectively. Age at diagnosis of SSc and delay since diagnosis were also independent factors of over-risk in association with malignancy. In subgroup analysis, the presence of interstitial lung disease or anti-topoisomerase was found predictive of lung cancer or cancer occuring more than three years after SSc Conclusion: in addition to confirming the value of anti-RNA POL 3 in the combination of SSc and cancer, our study highlights other important factors for clinical practice. In particular, the weight of anti-SSA antibodies and the specific organ damage are also to be taken into account in the estimation of the cancer risk for an SSc patient.
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Léa Lopez. Étude des caractéristiques cliniques et immunologiques des sclérodermies systémiques associées à des cancers : étude monocentrique rétrospective sur la cohorte Bordelaise. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02975208⟩

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