目 的：

        探索風濕性多肌痛(PMR)患者中腫瘤的發生率。

        方 法：

        收集英國實踐研究數據庫中的風濕性多肌痛患者2877人，除外曾診斷腫瘤、血管病的患者，患者均接受糖皮質激素治療。選用年齡、性別匹配的患者9942人;隨訪終點：第一次癌症診斷、死亡、移出數據庫或記錄結束。

        結 果：

        這些PMR患者的平均年齡71.6歲，73%為女性患者。隨訪中位年齡是7.8年。23.2%的PMR患者發生了腫瘤，高於對照組的19.5%。在PMR診斷的6個月內，PMR患者發生腫瘤的風險是1.69倍(1.18-2.24)。PMR診斷的6月內，雖腫瘤發生率不高，但下述腫瘤更常見：前列腺、血液、淋巴結、婦科、神經係統等部位。

        結 論：

        研究顯示在PMR診斷的6個月內腫瘤發生率較高。臨床醫師在診斷PMR時應充分的篩查腫瘤，對可能是腫瘤的患者進行嚴密監測。

        原 文

        Iscancerassociatedwithpolymyalgia rheumatica? Acohort studyin theGeneral PracticeResearchDatabase.

        Abstract

        OBJECTIVE:

        To investigate the incidence of newcancerdiagnoses in a community sample of patients withpolymyalgia rheumatica(PMR).

        METHODS:

        All incident cases of PMR in the UKGeneral PracticeResearchDatabase(GPRD) (1987-99), without pre-existingcanceror vascular disease and treated with corticosteroids (n=2877) were matched with up to five age, sex and GPpracticepatients without PMR (n=9942). Participants were followed up until firstcancerdiagnosis, death, transfer out of thedatabaseor end of available records.

        RESULTS:

        The mean age of the sample was 71.6years (SD 9.0), 73% were female. Median follow-up time was 7.8years (IQR 3.4, 12.3). 667 (23.2%) people with a PMR diagnosis developedcancercompared with 1938 (19.5%) of those without PMR. There was an interaction between PMR status and time. In the first 6months after diagnosis, those with a PMR diagnosis were significantly more likely to receive acancerdiagnosis (adjusted HR (95% CI): 1.69 (1.18 to 2.42)). The number of events was small, but occurrences of prostate, blood, lymph nodes, female reproductive and nervous systemcancersmay be more common in those with PMR in the first 6months after PMR diagnosis.

        CONCLUSIONS:

        An increase in the rate ofcancerdiagnoses was noted in the first 6months of observation, but we were unable to determine whether thecancerincidence in PMR was different from controls, beyond this time point. Clinicians should ensure they fully excludecanceras a cause of PMR-like symptoms and monitor patients for possible malignancies.

        文獻：Ann Rheum Dis.2014Oct;73(10):1769-73. doi: 10.1136/annrheumdis-2013-203465. Epub 2013 Jul 10.