Association between specific cancer types and polyarteritis nodosa among hospitalized patients in the United States.

Abstract

e18631 Background: Since immunization programs drastically reduced Hepatitis-B associated polyarteritis nodosa (PAN), the correlation between PAN and cancer has become more essential yet cancer types strongly linked with PAN remain poorly defined. We aim to quantify the association of specific cancer types with PAN. Methods: Adults admitted between 2016-2022 were recruited via the National Inpatient Sample, excluding COVID-19 cases. We identified myelodysplastic syndrome, Hodgkin lymphoma, non-Hodgkin lymphoma, chronic lymphocytic leukemia, hairy cell leukemia, chronic myelomonocytic leukemia, multiple myeloma, angioimmunoblastic T-cell lymphoma, gastric, lung, colon, renal cancers, cholangiocarcinoma, and PAN. Multivariable logistic regression estimated associations of each cancer versus controls without malignancy for PAN, reported as adjusted odds ratios (aOR), 95% confidence intervals (CI), and p-values, adjusted for age, sex, race, insurance, hospital characteristics, admission year, and comorbidities including hepatitis B/C, HIV/AIDS, autoimmune conditions, diabetes, hypertension, dyslipidemia, peripheral vascular disorders, heart failure, chronic kidney disease, liver disease, and COPD. Results: We evaluated over 199 million hospitalizations. Angioimmunoblastic T-cell lymphoma demonstrated the strongest association with PAN (aOR 8.146, 95% CI 2.471-26.855, p=0.001). Chronic myelomonocytic leukemia was also significantly associated (aOR 2.646, 95% CI 1.080-6.487, p=0.033). Lung cancer showed significant inverse association (aOR 0.634, 95% CI 0.445-0.902, p=0.011). Several hematologic malignancies showed elevated but non-significant associations: hairy cell leukemia (aOR 2.712, 95% CI 0.373-19.717, p=0.324), myelodysplastic syndrome (aOR 1.767, 95% CI 0.657-4.754, p=0.260), Hodgkin lymphoma (aOR 1.379, 95% CI 0.570-3.340, p=0.476), chronic lymphocytic leukemia (aOR 1.143, 95% CI 0.647-2.018, p=0.646), non-Hodgkin lymphoma (aOR 1.021, 95% CI 0.726-1.435, p=0.906). Multiple myeloma showed non-significant inverse association (aOR 0.748, 95% CI 0.426-1.314, p=0.312). Solid tumors showed non-significant inverse associations: gastric cancer (aOR 0.304, 95% CI 0.043-2.156, p=0.233), colon cancer (aOR 0.666, 95% CI 0.336-1.319, p=0.244), renal cancer (aOR 0.377, 95% CI 0.133-1.066, p=0.066), cholangiocarcinoma (aOR 0.752, 95% CI 0.173-3.259, p=0.703). Conclusions: Certain hematologic malignancies like angioimmunoblastic T-cell lymphoma and chronic myelomonocytic leukemia were most strongly linked with PAN supporting immune dysregulation in PAN pathogenesis. Lung cancer showed reduced association suggesting variability in immune response among cancer subtypes. Further studies should explore the cancer-PAN link.