Goggins W B, Finkelstein D M, Tsao H
Department of Mathematics, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
Cancer. 2001 Feb 15;91(4):874-80. doi: 10.1002/1097-0142(20010215)91:4<874::aid-cncr1076>3.0.co;2-o.
Over the past 2 decades both cutaneous melanoma (CM) and non-Hodgkin lymphoma (NHL) incidence rates have increased substantially. One approach to better understanding the etiologic basis for these increases is to examine the risk of NHL in CM survivors and the risk of CM in NHL survivors.
To explore the possible association between CM and NHL, the authors followed cohorts of CM and NHL patients registered through the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 1996 and identified patients who developed CM after NHL and NHL after CM. The number of observed cases then were compared with the number of expected cases to see if CM survivors were at an increased risk of NHL or if NHL survivors were at an increased risk of CM.
Between 1973 and 1996, 54,803 CM patients and 62,597 NHL patients who met the authors' inclusion criteria were identified through SEER. The authors found statistically significant elevated risks of NHL among CM survivors (standardized incidence ratio [SIR], 1.42; 95% confidence interval [CI], 1.23-1.63) and CM among NHL survivors (SIR, 1.75; 95% CI, 1.48-2.07).
These results support an association between CM and NHL. Although detection bias and posttherapy effects may explain part of this association, shared genetic or etiologic factors, such as sunlight exposure, also may play a role.
在过去20年中,皮肤黑色素瘤(CM)和非霍奇金淋巴瘤(NHL)的发病率均大幅上升。更好地理解这些上升的病因基础的一种方法是研究CM幸存者患NHL的风险以及NHL幸存者患CM的风险。
为了探索CM与NHL之间可能存在的关联,作者对1973年至1996年间通过美国国立癌症研究所的监测、流行病学和最终结果(SEER)计划登记的CM和NHL患者队列进行了随访,并确定了在患NHL后发生CM以及在患CM后发生NHL的患者。然后将观察到的病例数与预期病例数进行比较,以查看CM幸存者患NHL的风险是否增加,或者NHL幸存者患CM的风险是否增加。
在1973年至1996年间,通过SEER确定了54,803例符合作者纳入标准的CM患者和62,597例NHL患者。作者发现CM幸存者患NHL的风险有统计学意义的升高(标准化发病比[SIR],1.42;95%置信区间[CI],1.23 - 1.63),以及NHL幸存者患CM的风险有统计学意义的升高(SIR,1.75;95%CI,1.48 - 2.07)。
这些结果支持CM与NHL之间存在关联。尽管检测偏倚和治疗后效应可能解释了这种关联的一部分,但共同的遗传或病因因素,如阳光照射,也可能起作用。