Gregersen H, Mellemkjaer L, Salling Ibsen J, Sørensen H T, Olsen J H, Pedersen J O, Dahlerup J F
Department of Hematology B, Aalborg Hospital, Aalborg, Denmark.
Am J Hematol. 2000 Jan;63(1):1-6. doi: 10.1002/(sici)1096-8652(200001)63:1<1::aid-ajh1>3.0.co;2-m.
To assess the cancer risk of monoclonal gammopathy of undetermined significance (MGUS) we identified 1229 cases of MGUS in the period 1978 to 1993. Data on cancer occurrence in the MGUS cohort were obtained from the Danish Cancer Registry. The expected numbers of cancer cases were calculated from age-, sex-, county-, and period-specific cancer incidence rates. In the MGUS cohort 64 new cancers with a known association with M-components were diagnosed versus 5.0 expected giving a standardized incidence ratio (SIR) of 12.9 (95% confidence interval, 9.9-16.5). The relative risks of developing multiple myeloma (SIR 34.3), Waldenström's macroglobulinemia (SIR 63.8), and non-Hodgkin's lymphoma (SIR 5.9) were significantly increased and independent of time passed from detection of the M-component. The relative risk of chronic lymphocytic leukemia was not significantly increased, SIR 2.7 (0.5-7. 7). Among cancer sites without known association with M-components 141 cases were observed versus 94.6 expected giving a SIR of 1.5 (1. 3-1.8). This enhanced risk was seen for several non-hematological cancer sites but for most cancer sites the risk was dependent on time passed from detection of the M-component, indicating a bias rather than a causal role of MGUS.
为评估意义未明的单克隆丙种球蛋白病（MGUS）的癌症风险，我们确定了1978年至1993年期间的1229例MGUS病例。MGUS队列中癌症发生的数据来自丹麦癌症登记处。根据年龄、性别、县和时期特异性癌症发病率计算癌症病例的预期数量。在MGUS队列中，诊断出64例与M成分有已知关联的新发癌症，而预期为5.0例，标准化发病率（SIR）为12.9（95%置信区间，9.9 - 16.5）。发生多发性骨髓瘤（SIR 34.3）、华氏巨球蛋白血症（SIR 63.8）和非霍奇金淋巴瘤（SIR 5.9）的相对风险显著增加，且与从检测到M成分起经过的时间无关。慢性淋巴细胞白血病的相对风险未显著增加，SIR为2.7（0.5 - 7.7）。在与M成分无已知关联的癌症部位，观察到141例，预期为94.6例，SIR为1.5（1.3 - 1.8）。这种风险增加在几个非血液系统癌症部位可见，但对于大多数癌症部位，风险取决于从检测到M成分起经过的时间，这表明是一种偏差而非MGUS的因果作用。
