Goldin Lynn R, Pfeiffer Ruth M, Gridley Gloria, Gail Mitchell H, Li Xinjun, Mellemkjaer Lene, Olsen Jørgen H, Hemminki Kari, Linet Martha S
Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-7236, USA.
Cancer. 2004 May 1;100(9):1902-8. doi: 10.1002/cncr.20189.
The importance of genetic factors in the etiology of Hodgkin lymphoma (HL) has been suggested by family and population studies. However, the spectrum of malignancies associated with common genetic etiology and the effects of gender and age on familial risk have not been established.
Diagnoses of lymphoproliferative malignancies were compared in 15,799 first-degree relatives of 5047 patients with HL versus 32,117 first-degree relatives of 10,078 control probands from Sweden and in 7185 first-degree relatives of 2429 patients with HL versus 27,434 first-degree relatives of 8,495 control probands from Denmark using marginal survival models.
The risk of HL in relatives of patients with HL was increased significantly in both populations, with relative risks of 3.47 (95% confidence interval [95% CI], 1.77-6.80) in Sweden and 2.55 (95% CI, 1.01-6.45) in Denmark and a pooled estimate of 3.11 (95%CI, 1.82-5.29). In Sweden, risks for relatives of patients also were increased significantly for chronic lymphocytic leukemia and non-Hodgkin lymphoma (in males). Relative risks were higher in males compared with females and in siblings of patients compared with parents and offspring of patients. Relatives of patients with earlier-onset disease were at higher risk for HL.
HL has an important familial component, which is stronger in families of affected individuals age < 40 years, in males, and in siblings, and it is shared with some (but not other) lymphoproliferative malignancies. The cumulative lifetime risks are very small, however, for the development of HL de novo or in first-degree relatives of affected patients.
家族和人群研究提示遗传因素在霍奇金淋巴瘤(HL)病因学中具有重要作用。然而,与常见遗传病因相关的恶性肿瘤谱以及性别和年龄对家族风险的影响尚未明确。
采用边际生存模型,比较了瑞典5047例HL患者的15799名一级亲属与10078名对照先证者的32117名一级亲属,以及丹麦2429例HL患者的7185名一级亲属与8495名对照先证者的27434名一级亲属的淋巴增殖性恶性肿瘤诊断情况。
在这两个人群中,HL患者亲属患HL的风险均显著增加,瑞典的相对风险为3.47(95%置信区间[95%CI],1.77 - 6.80),丹麦为2.55(9�%CI,1.01 - 6.45),合并估计值为3.11(95%CI,1.82 - 5.29)。在瑞典,患者亲属患慢性淋巴细胞白血病和非霍奇金淋巴瘤(男性)的风险也显著增加。男性的相对风险高于女性,患者的兄弟姐妹的相对风险高于父母和子女。发病较早的患者亲属患HL的风险更高。
HL具有重要的家族聚集性,在年龄<40岁的患者家庭、男性患者家庭以及兄弟姐妹中更为明显,并且与某些(但不是其他)淋巴增殖性恶性肿瘤存在共同遗传因素。然而,HL新发或在受影响患者的一级亲属中发生的累积终生风险非常小。