The risk of leukemia in patients with rheumatoid arthritis: a systematic review and meta-analysis

Four genes shared between rheumatoid arthritis and cervical cancer are associated with cervical cancer prognosis

Rheumatoid arthritis (RA) and cervical cancer (CC) are major global health challenges, yet the molecular connections between these two conditions remain poorly understood. To bridge this gap, our study employs bioinformatics approaches to explore shared genetic pathways and potential biomarkers. We started by identifying differentially expressed genes in RA and CC and then applied WGCNA to detect functionally related gene clusters using gene expression data from the GEO database. Additionally, we constructed protein-protein interaction (PPI) networks and examined the role of the immune microenvironment. To assess the prognostic relevance of key genes in CC, we leveraged survival data from TCGA. Our analysis identified 55 key genes common to RA and CC, with four-CXCL1, CXCL13, ZWINT, and PTTG1-emerging as significant. ROC curve validation confirmed their diagnostic potential, and a model incorporating these genes was associated with poorer prognosis in CC. Among them, CXCL1 stood out as especially crucial. Our findings suggest a potential link between chronic inflammation, immune dysregulation, and chemokine-related pathways in RA patients, which may contribute to an increased susceptibility to CC.

Risk relationship between six autoimmune diseases and malignancies: An umbrella review

BACKGROUND

The bidirectional relationship between autoimmune diseases and malignancy has been widely discussed. And the relationship between autoimmune diseases and the risk of malignancy varies. Here, we categorized and re-analyzed the evidence of the association between six autoimmune diseases and malignancy risk, in order to provide ideas for the prevention of malignancy in the long-term individualized management of patients with autoimmune diseases.

METHODS

We systematically searched the relevant literatures in PubMed, Web of Science and Cochrane Library to identify and re-analyze studies methodically on the association between six autoimmune diseases and their malignancy risk. Our results showed that.

RESULTS

We included 34 meta-analyses including systematic lupus erythematosus, rheumatoid arthritis, psoriasis, ankylosing spondylitis, primary Sjogren's syndrome, multiple sclerosis, totalling 742 studies. Our results showed that the remaining five AIDs, with the exception of MS, were positively associated with the risk of overall malignancy. Among them, patients with SLE had the highest risk of developing lymphomas, oropharyngeal cancer and non-Hodgkin's lymphoma, and the lowest risk of developing uterine cancer, melanoma and endometrial cancer. The RA patients had the highest risk of developing lymphomas, Hodgkin's lymphoma and non-Hodgkin's and the lowest risk of colon cancer. pSS patients had the highest risk of lymphoma. MS patients had the highest risk of lung cancer and the lowest risk of testicular cancer. AS patients had the highest risk of lymphoblastic leukemia. PsO patients had the highest risk of keratinocyte cancer.

CONCLUSION

Patients with systematic lupus erythematosus, rheumatoid arthritis, psoriasis, ankylosing spondylitis and primary Sjogren's syndrome lead to an increased risk of overall malignancy, whereas patients with MS lead to a decreased risk of overall malignancy. However, the risk relationship between the same AIDs and different malignancies varied.

Cancer Incidence and Outcome for Patients With Rheumatoid Arthritis: A Long-term Population Study in Western Australia

OBJECTIVE

Our aim was to compare the incidence of malignancy and its effect on mortality between hospitalized patients with rheumatoid arthritis (RA) and controls.

METHODS

We conducted a population-level observational study of patients with RA (International Classification of Diseases, 9th revision, Clinical Modification [ICD-9-CM] code 714 and International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification [ICD-10-AM] codes M05-M06) in the Hospital Morbidity Data Collection (HMDC) in Western Australia (WA) between 1985 and 2015, as well as nonexposed hospitalized controls matched on sex, age, and year of index admission. HMDC data were linked to the WA Cancer Registry and the WA Death Registry data, and cancer incidence rates (CIRs) per 1000 person-years, incidence rate ratios (IRR) with 95% CIs, and Kaplan Meier survival were estimated.

RESULTS

Among 14,041 patients with RA (67.56% female, median age 65.1 years) and 33,785 controls (65.16% female, median age 65.3 years), preexisting cancer in patients with RA was less prevalent than in controls (7.6% vs 14.2%; P < 0.01). In participants without prior cancer, the overall post index CIR was lower in those with RA (CIR 19.68 vs 24.77; IRR 0.79, 95% CI 0.76-0.83) and stable over 3 study decades. CIR was higher in patients with RA for lung (CIR 1.17, 95% CI 1.04-1.34) and hematological cancer (CIR 1.21, 95% CI 1.03-1.43) but lower for most other cancer types. Overall median survival was lower for patients with RA than controls (3.3 vs 5.3 years; P < 0.001) with increased mortality rates observed for most cancer subtypes.

CONCLUSION

Overall CIR in patients with RA was consistently lower over time than in matched controls. CIR was only increased for lung and hematological cancer. Despite the overall lower CIR, post cancer mortality was higher for patients with RA in most cancer subtypes.

Rheumatoid arthritis and cancer risk in the Million Women Study

BACKGROUND

Most previous studies of rheumatoid arthritis (RA) and cancer risk have lacked information on potential confounding factors. We investigated RA-associated cancer risks in a large cohort of women in the UK, taking account of shared risk factors.

METHODS

In 1996-2001, women aged 50-64, who were invited for routine breast screening at 66 National Health Service (NHS) screening centres in England and Scotland, were also invited to take part in the Million Women Study. Participants provided information on sociodemographic, lifestyle and health-related factors, including RA, and were followed up for cancers and deaths. Cox regression yielded RA-associated hazard ratios (HRs) of 20 cancers, adjusted for 10 characteristics including smoking status and adiposity.

RESULTS

Around 1.3 million women (half of those invited) were recruited into the study. In minimally adjusted analyses, RA was associated with the risk of 13 of the 20 cancers. After additional adjustment for lifestyle factors, many of these associations were attenuated but there remained robust evidence of RA-associated increases in the risk of lung (HR 1.21, 95% confidence interval 1.15-1.26), lymphoid (1.25, 1.18-1.33), myeloid (1.12, 1.01-1.25), cervical (1.39, 1.11-1.75) and oropharyngeal (1.40, 1.21-1.61) cancers, and decreases in the risk of endometrial (0.84, 0.77-0.91) and colorectal (0.82, 0.77-0.87) cancers.

CONCLUSIONS

After taking account of shared risk factors, RA is positively associated with lung and certain blood and infection-related cancers, and inversely associated with colorectal cancer. These findings are consistent with existing hypotheses around immune response, susceptibility to infections, and chronic inflammation. The inverse association observed for endometrial cancer merits further investigation.

Exploring the relationship between immune heterogeneity characteristic genes of rheumatoid arthritis and acute myeloid leukemia

BACKGROUND

People with autoimmune diseases are prone to cancer, and there is a close relationship between rheumatoid arthritis (RA) and acute myeloid leukemia (AML). The bone marrow (BM) is affected throughout the course of RA, with a variety of hematologic involvement. Hopes are pinned on rheumatoid arthritis research to obtain BM biomarkers for AML.

METHODS

Synovial transcriptome sequencing data for RA and osteoarthritis (OA), and single-cell sequencing data for RA and controls were obtained from the GEO database.Bone marrow sequencing data for AML patients and normal subjects were obtained from the UCSC Xena database. The final immune heterogeneity characteristics of RA were determined through ssGSEA analysis, gene differential expression analysis, fuzzy c-means clustering algorithm, and XGboost algorithm. Random Ferns classifiers (RFs) are used to identify new bone marrow markers for AML.

RESULTS

SELL, PTPRC, IL7R, CCR7, and KLRB1 were able to distinguish leukemia cells from normal cells well, with AUC values higher than 0.970.

CONCLUSION

Genes characterizing the immune heterogeneity of RA are associated with AML, and KLRBA may be a potential target for AML treatment.

Rheumatoid arthritis and risk of site-specific cancers: Mendelian randomization study in European and East Asian populations

BACKGROUND

The associations of rheumatoid arthritis (RA) with risk of site-specific cancers beyond lymphohematopoietic cancer have been scarcely explored. We conducted a Mendelian randomization investigation of the associations of RA with site-specific cancers in European and East Asian populations.

METHODS

Independent genetic variants strongly associated with RA in European and East Asian populations were selected as instrumental variables from genome-wide association studies of 58,284 European individuals (14,361 cases and 43,923 controls) and 22,515 East Asian individuals (4873 cases and 17,642 controls), respectively. The associations of genetic variants with overall and 22 site-specific cancers were extracted from the UK Biobank study (n = 367,561), the FinnGen study (n = 260,405), Biobank Japan (n = 212,453), and international consortia. The associations for one outcome from different data sources were combined by meta-analysis.

RESULTS

In the European population, the combined odds ratios per 1-unit increase in log odds of genetic liability to RA were 1.06 (95% confidence interval [CI] 1.03-1.10) for head and neck cancer, 1.06 (95% CI 1.02-1.10) for cervical cancer, 0.92 (95% CI 0.87-0.96) for testicular cancer, and 0.94 (95% CI 0.90-0.98) for multiple myeloma. In the East Asian population, the corresponding odds ratios were 1.17 (95% CI 1.06-1.29) for pancreatic cancer, 0.91 (95% CI 0.88-0.94) for breast cancer, and 0.90 (95% CI 0.84-0.96) for ovarian cancer. There were suggestive associations for breast and ovarian cancer and overall cancer in the European population. No other associations were observed.

CONCLUSION

This study suggests that RA may play a role in the development of several site-specific cancers.