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Predicting the risk for lymphoma development in Sjogren syndrome

View Article: PubMed Central - PubMed

ABSTRACT

The heightened risk of non-Hodgkin lymphoma (NHL) development in primary Sjogren syndrome (SS) is well established. Several adverse clinical and laboratory predictors have been described. In the current work, we aimed to formulate a predictive score for NHL development, based on clinical, serological, and histopathological findings at the time of SS diagnosis. In the present case–control study of 381 primary SS patients and 92 primary SS patients with concomitant NHL, clinical, serological, and histopathological variables at the time of SS diagnosis were retrospectively recorded. For the identification of predictors for NHL development univariate and multivariate models were constructed. Salivary gland enlargement (SGE), lymphadenopathy, Raynaud phenomenon, anti-Ro/SSA or/and anti-La/SSB autoantibodies, rheumatoid factor (RF) positivity, monoclonal gammopathy, and C4 hypocomplementemia were shown to be independent predictors for NHL development. On the basis of the number of independent risk factors identified, a predictive risk score for NHL development was formulated. Thus, patients presenting with ≤2 risk factors had a 3.8% probability of NHL development, those with 3 to 6 risk factors 39.9% (OR (95%CI): 16.6 [6.5–42.5], P < 0.05), while in the presence of all 7 risk factors the corresponding probability reached 100% (OR [95%CI]: 210.0 [10.0–4412.9], P < 0.0001). In conclusion, an easy to use diagnostic scoring tool for NHL development in the context of SS is presented. This model is highly significant for the design of early therapeutic interventions in high risk SS patients for NHL development.

No MeSH data available.


Related in: MedlinePlus

The probability of NHL development among SS patients was estimated on the basis of the number of independent risk factors. The probability of NHL development was 3.8% for patients presenting with ≤2 risk factors, 39.9% for those displaying 3 to 6 risk factors, and 100% in the presence of all 7 risk factors. The OR along with the corresponding CI and P-values for NHL development in the presence of all 7 risk factors were 210.0 (10.0–4412.9), P < 0.0001 compared to those with 2 or less risk factors. The corresponding values in the presence of 3 to 6 risk factors were 16.6 (6.5–42.5), P < 0.05 in comparison with those with 2 or less risk factors. CI = confidence interval, NHL = non-Hodgkin lymphoma, OR = odds ratio, SS = Sjogren syndrome.
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Figure 3: The probability of NHL development among SS patients was estimated on the basis of the number of independent risk factors. The probability of NHL development was 3.8% for patients presenting with ≤2 risk factors, 39.9% for those displaying 3 to 6 risk factors, and 100% in the presence of all 7 risk factors. The OR along with the corresponding CI and P-values for NHL development in the presence of all 7 risk factors were 210.0 (10.0–4412.9), P < 0.0001 compared to those with 2 or less risk factors. The corresponding values in the presence of 3 to 6 risk factors were 16.6 (6.5–42.5), P < 0.05 in comparison with those with 2 or less risk factors. CI = confidence interval, NHL = non-Hodgkin lymphoma, OR = odds ratio, SS = Sjogren syndrome.

Mentions: Binary logistic regression was used to calculate the predicted probability of NHL development. Only patients with full data available (325 patients out of 373, 87% of the initial cohort) were analyzed. In the absence of those 7 risk factors, none of the SS patients in the cohort had lymphoma. Patients presenting with ≤2 had a 3.8% probability of NHL development. The probability of NHL development in the presence of 3 to 6 risk factors was 39.9%, while in the presence of all 7 risk factors was 100%. The ORs along with the corresponding CIs and P-values for NHL development in the presence of all 7 risk factors were 210.0 (10.0–4412.9), P < 0.0001 compared to those with 2 or less risk factors. The corresponding values in the presence of 3 to 6 risk factors were 16.6 (6.5–42.5), P < 0.05 in comparison with patients presenting with 2 or less risk factors (Fig. 3).


Predicting the risk for lymphoma development in Sjogren syndrome
The probability of NHL development among SS patients was estimated on the basis of the number of independent risk factors. The probability of NHL development was 3.8% for patients presenting with ≤2 risk factors, 39.9% for those displaying 3 to 6 risk factors, and 100% in the presence of all 7 risk factors. The OR along with the corresponding CI and P-values for NHL development in the presence of all 7 risk factors were 210.0 (10.0–4412.9), P < 0.0001 compared to those with 2 or less risk factors. The corresponding values in the presence of 3 to 6 risk factors were 16.6 (6.5–42.5), P < 0.05 in comparison with those with 2 or less risk factors. CI = confidence interval, NHL = non-Hodgkin lymphoma, OR = odds ratio, SS = Sjogren syndrome.
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4998301&req=5

Figure 3: The probability of NHL development among SS patients was estimated on the basis of the number of independent risk factors. The probability of NHL development was 3.8% for patients presenting with ≤2 risk factors, 39.9% for those displaying 3 to 6 risk factors, and 100% in the presence of all 7 risk factors. The OR along with the corresponding CI and P-values for NHL development in the presence of all 7 risk factors were 210.0 (10.0–4412.9), P < 0.0001 compared to those with 2 or less risk factors. The corresponding values in the presence of 3 to 6 risk factors were 16.6 (6.5–42.5), P < 0.05 in comparison with those with 2 or less risk factors. CI = confidence interval, NHL = non-Hodgkin lymphoma, OR = odds ratio, SS = Sjogren syndrome.
Mentions: Binary logistic regression was used to calculate the predicted probability of NHL development. Only patients with full data available (325 patients out of 373, 87% of the initial cohort) were analyzed. In the absence of those 7 risk factors, none of the SS patients in the cohort had lymphoma. Patients presenting with ≤2 had a 3.8% probability of NHL development. The probability of NHL development in the presence of 3 to 6 risk factors was 39.9%, while in the presence of all 7 risk factors was 100%. The ORs along with the corresponding CIs and P-values for NHL development in the presence of all 7 risk factors were 210.0 (10.0–4412.9), P < 0.0001 compared to those with 2 or less risk factors. The corresponding values in the presence of 3 to 6 risk factors were 16.6 (6.5–42.5), P < 0.05 in comparison with patients presenting with 2 or less risk factors (Fig. 3).

View Article: PubMed Central - PubMed

ABSTRACT

The heightened risk of non-Hodgkin lymphoma (NHL) development in primary Sjogren syndrome (SS) is well established. Several adverse clinical and laboratory predictors have been described. In the current work, we aimed to formulate a predictive score for NHL development, based on clinical, serological, and histopathological findings at the time of SS diagnosis. In the present case&ndash;control study of 381 primary SS patients and 92 primary SS patients with concomitant NHL, clinical, serological, and histopathological variables at the time of SS diagnosis were retrospectively recorded. For the identification of predictors for NHL development univariate and multivariate models were constructed. Salivary gland enlargement (SGE), lymphadenopathy, Raynaud phenomenon, anti-Ro/SSA or/and anti-La/SSB autoantibodies, rheumatoid factor (RF) positivity, monoclonal gammopathy, and C4 hypocomplementemia were shown to be independent predictors for NHL development. On the basis of the number of independent risk factors identified, a predictive risk score for NHL development was formulated. Thus, patients presenting with &le;2 risk factors had a 3.8% probability of NHL development, those with 3 to 6 risk factors 39.9% (OR (95%CI): 16.6 [6.5&ndash;42.5], P&#8202;&lt;&#8202;0.05), while in the presence of all 7 risk factors the corresponding probability reached 100% (OR [95%CI]: 210.0 [10.0&ndash;4412.9], P&#8202;&lt;&#8202;0.0001). In conclusion, an easy to use diagnostic scoring tool for NHL development in the context of SS is presented. This model is highly significant for the design of early therapeutic interventions in high risk SS patients for NHL development.

No MeSH data available.


Related in: MedlinePlus