BFGF could be a biomarker of malignancy in RS3PE syndrome: an ambispective single-center cohort analysis of 51 patients

Yuzhou Gan,Xue Li,Hua Ye,Yifan Wang,Jiali Chen,Yi Sun,Jiayang Jin,Yukchiu Chung

doi:10.1186/s13075-021-02638-0

Abstract

ObjectivesRemitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare inflammatory arthritis, with a higher incidence of malignancy. The aim of this study is to identify biomarkers for predicting malignancy in RS3PE.MethodsA total of 51 patients with RS3PE from September 2007 to May 2019 were retrospectively reviewed and followed for up to 5 years, with 15 patients with osteoarthritis (OA) and 14 patients with elderly-onset rheumatoid arthritis (EORA) as disease controls. Serum levels of angiogenesis cytokines were measured by electrochemiluminescent immunoassay and Luminex Human Magnetic Assay. Clinical data and laboratory parameters were analyzed to identify risk factors for malignancy.ResultsA total of forty-eight RS3PE patients (94.1%) were available with follow-up data; 8 patients (16.7%) were diagnosed with malignancy, of which 6 patients were hematological tumor; and 2 patients were solid tumors. Serum levels of basic fibroblast growth factor (bFGF) were exclusively higher in RS3PE patients with malignancy [14.21 (7.52, 23.18) ng/mL] than RS3PE patients without malignancy [4.32 (2.88, 7.42) ng/mL], OA [3.20 (2.20, 5.30) ng/mL], and EORA [3.20 (2.20, 5.30) ng/mL]. The optimal cut-off value of bFGF for malignancy was 10ng/mL in RS3PE. Logistic regression analysis indicated that elevation of bFGF was a risk factor for malignancy in RS3PE.ConclusionsThis study indicated that bFGF was elevated in RS3PE patients with malignancy and could serve as a biomarker for predicting paraneoplastic RS3PE.

Highlights

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare elderly-onset inflammatory arthritis, characterized by symmetrical involvement of small joints and marked pitting edema on the dorsum of the hands and feet [1, 2]
Since angiogenesis plays an important role in the pathogenesis and progression of cancer, we simultaneously evaluated the serum levels of 12 angiogenesis cytokines in paraneoplastic RS3PE, comparing with idiopathic RS3PE, osteoarthritis (OA), and elderly-onset rheumatoid arthritis (EORA) in the current study
Patients had an elevated level of C-reactive protein (CRP) (43.9 [22.8, 82.0] mg/dL) and erythrocyte sedimentation rate (ESR) (55.37±34.12 mm/h)

Summary

Introduction

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare elderly-onset inflammatory arthritis, characterized by symmetrical involvement of small joints and marked pitting edema on the dorsum of the hands and feet [1, 2]. Previous studies have found two angiogenesis cytokines, namely vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP)-3, were involved in the pathogenesis of R S3PE along with malignancy [5,6,7,8]. Later findings indicated that elevated levels of VEGF were characteristics of infections and organizing pneumonia in RS3PE [9, 10]. MMP-3 was elevated in R S3PE patients with solid malignancy [11], but it was an indicator for active arthritis [12]

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