Landgren Ola, Björkholm Magnus, Montgomery Scott M, Hjalgrim Henrik, Sjöberg Jan, Goldin Lynn R, Askling Johan
Division of Hematology, Karolinska Hospital and Institutet, Stockholm, Sweden.
Int J Cancer. 2006 Jan 15;118(2):449-52. doi: 10.1002/ijc.21347.
Young-adult-onset (15-44 years of age) Hodgkin lymphoma (HL) is believed to arise as a consequence of late primary infection in susceptible individuals. The properties of this susceptibility remain little understood. We have previously reported an increased occurrence of HL in patients with rheumatoid arthritis and among their offspring, suggesting that susceptibility to autoimmunity might be of importance also in the pathogenesis of HL. To explore this hypothesis, we assessed the association of personal and family history of diabetes mellitus, with risk of subsequent HL in a population-based case-control study, including as cases all individuals diagnosed with HL above 15 years of age 1964-1999 (n = 6,873) in Sweden, and matched population controls (n = 12,565). First-degree relatives of cases and controls were identified through linkage with the Multi-generation Register. We identified discharges listing diabetes mellitus through linkage with the Inpatient Register (1964-2000). We used odds ratios (OR) as measures of relative risk. Cases with young-adult-onset HL were less likely to have a personal (OR =0.5, 95% CI 0.2-1.1) or family (OR =0.7, 95% CI 0.6-0.8) history of diabetes mellitus. In contrast, HL diagnosed at older ages was neither associated with a personal (OR =1.0) nor family (OR =1.0) history of diabetes mellitus. These findings suggests that characteristics of the immune system associated with conditions such as diabetes mellitus type I are of importance in the pathogenesis of young-adult-onset HL.
青年期发病（15 - 44岁）的霍奇金淋巴瘤（HL）被认为是易感个体初次感染较晚的结果。这种易感性的特性仍鲜为人知。我们之前报道过类风湿性关节炎患者及其后代中HL的发病率增加，这表明自身免疫易感性在HL的发病机制中可能也很重要。为了探究这一假设，我们在一项基于人群的病例对照研究中评估了糖尿病个人史和家族史与后续患HL风险的关联，该研究的病例包括1964 - 1999年在瑞典所有15岁以上被诊断为HL的个体（n = 6,873），并匹配了人群对照（n = 12,565）。通过与多代登记册的关联确定病例和对照的一级亲属。通过与住院登记册（1964 - 2000）的关联识别列出糖尿病的出院记录。我们使用比值比（OR）作为相对风险的衡量指标。青年期发病的HL患者个人患糖尿病史（OR = 0.5，95% CI 0.2 - 1.1）或家族患糖尿病史（OR = 0.7，95% CI 0.6 - 0.8）的可能性较小。相比之下，老年期诊断的HL与个人患糖尿病史（OR = 1.0）或家族患糖尿病史（OR = 1.0）均无关联。这些发现表明，与I型糖尿病等疾病相关的免疫系统特征在青年期发病的HL发病机制中具有重要意义。
