Background/Purpose: Anti-Ro52 antibodies are frequently detected in patients with systemic autoimmune rheumatic diseases (SARDs). Emerging evidence suggests a potential link between isolated anti-Ro52 positivity and increased malignancy risk.Our aim was to evaluate: a) the association between anti-Ro52 antibody status (negative, isolated, or combined with other autoantibodies) and malignancy risk; b) whether malignancy types differ according to anti-Ro52 status.

Methods: We conducted a retrospective study of 739 patients who underwent immunoblot testing for autoimmune inflammatory myopathies or systemic sclerosis at a university hospital between November 2017 and October 2023. Patients were stratified by anti-Ro52 status: negative, isolated positivity, or combined with other myositis- or sclerosis-related antibodies. Clinical records were reviewed to confirm SARDs diagnoses using established classification criteria and to identify malignancies through clinical and/or pathological documentation. Associations were analyzed using logistic regression adjusted for age, sex, and SARDs diagnosis.

Results: Malignancy was identified in 61 of 739 patients (8.25%). Anti-Ro52 status distribution: negative (81.4%, n=602), isolated (12.7%, n=94), and combined positivity (5.8%, n=43). In multivariable analysis, older age and isolated Ro52 positivity were independently associated with increased malignancy risk. Each additional year of age increased risk by 5.3% (OR 1.053; 95% CI 1.031–1.076; p< 0.001). Isolated Ro52 positivity conferred a nearly fourfold increased risk versus seronegative patients (OR 3.968; 95% CI 2.049–7.687; p< 0.001). SARDs diagnosis was inversely associated with malignancy (OR 0.426; 95% CI 0.240–0.759; p=0.004). No significant associations were found for sex (OR 0.693; 95% CI 0.392–1.224; p=0.206) or Ro52 positivity combined with other antibodies (OR 1.063; 95% CI 0.297–3.807; p=0.925).A secondary analysis revealed significant differences in malignancy types by Ro52 status (p=0.001). Ro52-positive patients showed higher frequencies of ovarian, lung, and urothelial cancers, while the Ro52-negative group exhibited a broader, more heterogeneous profile, including colorectal, gastric, and hematological malignancies.

Conclusion: Isolated anti-Ro52 positivity and advancing age are independent predictors of malignancy. The distinct cancer spectrum among Ro52-positive patients suggests the importance of tailored oncologic surveillance in this subgroup.

FIGURE. Distribution of Ro52 Positivity and Negativity in Patients With and Without Neoplasia

TABLE. Demographic, Clinical, and Neoplastic Characteristics of Patients Categorized by Anti-Ro52 Antibody Status

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/isolated-anti-ro52-antibody-positivity-is-associated-with-increased-cancer-risk-and-distinct-malignancy-patterns-a-retrospective-cohort-study-from-a-single-tertiary-center/