Brennan P, Scélo G, Hemminki K, Mellemkjaer L, Tracey E, Andersen A, Brewster D H, Pukkala E, McBride M L, Kliewer E V, Tonita J M, Seow A, Pompe-Kirn V, Martos C, Jonasson J G, Colin D, Boffetta P
International Agency for Research on Cancer, 69008 Lyon, France.
Br J Cancer. 2005 Jul 11;93(1):159-66. doi: 10.1038/sj.bjc.6602654.
An analysis of other primary cancers in individuals with non-Hodgkin's lymphoma (NHL) can help to elucidate this cancer aetiology. In all, 109 451 first primary NHL were included in a pooled analysis of 13 cancer registries. The observed numbers of second cancers were compared to the expected numbers derived from the age-, sex-, calendar period- and registry-specific incidence rates. We also calculated the standardised incidence ratios for NHL as a second primary after other cancers. There was a 47% (95% confidence interval 43-51%) overall increase in the risk of a primary cancer after NHL. A strongly significant (P<0.001) increase was observed for cancers of the lip, tongue, oropharynx*, stomach, small intestine, colon*, liver, nasal cavity*, lung, soft tissues*, skin melanoma*, nonmelanoma skin*, bladder*, kidney*, thyroid*, Hodgkin's lymphoma*, lymphoid leukaemia* and myeloid leukaemia. Non-Hodgkin's lymphoma as a second primary was increased after cancers marked with an asterisk. Patterns of risk indicate a treatment effect for lung, bladder, stomach, Hodgkin's lymphoma and myeloid leukaemia. Common risk factors may be involved for cancers of the lung, bladder, nasal cavity and for soft tissues, such as pesticides. Bidirectional effects for several cancer sites of potential viral origin argue strongly for a role for immune suppression in NHL.
对非霍奇金淋巴瘤（NHL）患者的其他原发性癌症进行分析有助于阐明这种癌症的病因。总共109451例原发性NHL被纳入13个癌症登记处的汇总分析。将观察到的第二癌症数量与根据年龄、性别、日历期和登记处特定发病率得出的预期数量进行比较。我们还计算了NHL作为其他癌症后的第二原发性癌症的标准化发病率比。NHL后原发性癌症的风险总体增加了47%（95%置信区间43 - 51%）。唇癌、舌癌、口咽癌*、胃癌、小肠癌、结肠癌*、肝癌、鼻腔癌*、肺癌、软组织癌*、皮肤黑色素瘤*、非黑色素瘤皮肤癌*、膀胱癌*、肾癌*、甲状腺癌*、霍奇金淋巴瘤*、淋巴样白血病*和髓样白血病的发病率显著增加（P<0.001）。带星号标记的癌症后，非霍奇金淋巴瘤作为第二原发性癌症的发病率增加。风险模式表明对肺癌、膀胱癌、胃癌、霍奇金淋巴瘤和髓样白血病有治疗作用。肺癌、膀胱癌、鼻腔癌和软组织癌（如农药）可能涉及共同的风险因素。几种潜在病毒起源的癌症部位的双向影响有力地证明了免疫抑制在NHL中的作用。
