Catassi Carlo, Fabiani Elisabetta, Corrao Giovanni, Barbato Maria, De Renzo Amalia, Carella Angelo M, Gabrielli Armando, Leoni Pietro, Carroccio Antonio, Baldassarre Mariella, Bertolani Paolo, Caramaschi Paola, Sozzi Michele, Guariso Graziella, Volta Umberto, Corazza Gino R
University of Maryland, Division of Pediatric Gastroenterology and Nutrition, 22 S Greene St, N5W70/Box 140, Baltimore, MD 21201, USA.
JAMA. 2002 Mar 20;287(11):1413-9. doi: 10.1001/jama.287.11.1413.
Celiac disease is one of the most common lifelong disorders. Non-Hodgkin lymphoma is a possible complication of celiac disease and may lead to a large portion of lymphoma cases.
To quantify the risk for developing non-Hodgkin lymphoma of any primary site associated with celiac disease.
Multicenter, case-control study conducted between January 1996 and December 1999 throughout Italy.
Cases were older than 20 years (median, 57; range, 20-92 years) with non-Hodgkin lymphoma of any primary site and histological type and were recruited at the time of the diagnosis. Controls were healthy adults (2739 men and 2981 women) from the general population.
Positive test result for class A serum antiendomysial antibody.
Celiac disease was diagnosed in 6 (0.92%) of 653 patients with lymphoma. Of the 6 cases, 3 were of B-cell and 3 were of T-cell origin. Four of 6 cases had lymphoma primarily located in the gut. In the control group, 24 (0.42%) had celiac disease. The odds ratio (adjusted for age and sex) for non-Hodgkin lymphoma of any primary site associated with celiac disease was 3.1 (95% confidence interval [CI], 1.3-7.6), 16.9 (95% CI, 7.4-38.7) for gut lymphoma, and 19.2 (95% CI, 7.9-46.6) for T-cell lymphoma, respectively. The risk for non-Hodgkin lymphoma for the overall population, which was adjusted for age and sex, was 0.63% (95% CI, - 0.12% to 1.37%).
Celiac disease is associated with an increased risk for non-Hodgkin lymphoma, especially of T-cell type and primarily localized in the gut. However, the association does not represent a great enough risk to justify early mass screening for celiac disease.
乳糜泻是最常见的终身性疾病之一。非霍奇金淋巴瘤是乳糜泻可能的并发症，可能导致很大一部分淋巴瘤病例。
量化与乳糜泻相关的任何原发部位发生非霍奇金淋巴瘤的风险。
1996年1月至1999年12月在意大利全境进行的多中心病例对照研究。
病例为年龄大于20岁（中位数57岁；范围20 - 92岁），患有任何原发部位和组织学类型的非霍奇金淋巴瘤，在诊断时招募。对照为来自普通人群的健康成年人（2739名男性和2981名女性）。
A类血清抗肌内膜抗体检测结果呈阳性。
653例淋巴瘤患者中有6例（0.92%）被诊断为乳糜泻。6例病例中，3例为B细胞起源，3例为T细胞起源。6例中有4例淋巴瘤主要位于肠道。在对照组中，24例（0.42%）患有乳糜泻。与乳糜泻相关的任何原发部位非霍奇金淋巴瘤的比值比（经年龄和性别校正）为3.1（95%置信区间[CI]，1.3 - 7.6），肠道淋巴瘤为16.9（95%CI，7.4 - 38.7），T细胞淋巴瘤为19.2（95%CI，7.9 - 46.6）。经年龄和性别校正后的总体人群中非霍奇金淋巴瘤风险为0.63%（95%CI， - 0.12%至1.37%）。
乳糜泻与非霍奇金淋巴瘤风险增加相关，尤其是T细胞型且主要局限于肠道。然而，这种关联风险不足以证明对乳糜泻进行早期大规模筛查是合理的。
