Landgren Ola, Engels Eric A, Pfeiffer Ruth M, Gridley Gloria, Mellemkjaer Lene, Olsen Jørgen H, Kerstann Kimberly F, Wheeler William, Hemminki Kari, Linet Martha S, Goldin Lynn R
Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7236, USA.
J Natl Cancer Inst. 2006 Sep 20;98(18):1321-30. doi: 10.1093/jnci/djj361.
Personal history of autoimmune diseases is consistently associated with increased risk of non-Hodgkin lymphoma. In contrast, there are limited data on risk of Hodgkin lymphoma following autoimmune diseases and almost no data addressing whether there is a familial association between the conditions.
Using population-based linked registry data from Sweden and Denmark, 32 separate autoimmune and related conditions were identified from hospital diagnoses in 7476 case subjects with Hodgkin lymphoma, 18,573 matched control subjects, and more than 86,000 first-degree relatives of case and control subjects. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) as measures of relative risks for each condition using logistic regression and also applied multivariable hierarchical regression models. All P values are two-sided.
We found statistically significantly increased risks of Hodgkin lymphoma associated with personal histories of several autoimmune conditions, including rheumatoid arthritis (OR = 2.7, 95% CI = 1.9 to 4.0), systemic lupus erythematosus (OR = 5.8, 95% CI = 2.2 to 15.1), sarcoidosis (OR = 14.1, 95% CI = 5.4 to 36.8), and immune thrombocytopenic purpura (OR = infinity, P = .002). A statistically significant increase in risk of Hodgkin lymphoma was associated with family histories of sarcoidosis (OR = 1.8, 95% CI = 1.01 to 3.1) and ulcerative colitis (OR = 1.6, 95% CI = 1.02 to 2.6).
Personal or family history of certain autoimmune conditions was strongly associated with increased risk of Hodgkin lymphoma. The association between both personal and family histories of sarcoidosis and a statistically significantly increased risk of Hodgkin lymphoma suggests shared susceptibility for these conditions.
自身免疫性疾病的个人病史一直与非霍奇金淋巴瘤风险增加相关。相比之下，关于自身免疫性疾病后霍奇金淋巴瘤风险的数据有限，几乎没有数据涉及这两种疾病之间是否存在家族关联。
利用瑞典和丹麦基于人群的关联登记数据，从7476例霍奇金淋巴瘤病例、18573例匹配对照以及病例和对照的86000多名一级亲属的医院诊断中识别出32种单独的自身免疫性及相关疾病。我们使用逻辑回归计算每种疾病的比值比（OR）和95%置信区间（CI）作为相对风险的衡量指标，并应用多变量分层回归模型。所有P值均为双侧。
我们发现，几种自身免疫性疾病的个人病史与霍奇金淋巴瘤风险在统计学上显著增加相关，包括类风湿性关节炎（OR = 2.7，95%CI = 1.9至4.0）、系统性红斑狼疮（OR = 5.8，95%CI = 2.2至15.1）、结节病（OR = 14.1，95%CI = 5.4至36.8）和免疫性血小板减少性紫癜（OR = 无穷大，P = 0.002）。结节病（OR = 1.8，95%CI = 1.01至3.1）和溃疡性结肠炎（OR = 1.6，95%CI = 1.02至2.6）的家族病史与霍奇金淋巴瘤风险在统计学上显著增加相关。
某些自身免疫性疾病的个人或家族病史与霍奇金淋巴瘤风险增加密切相关。结节病的个人和家族病史与霍奇金淋巴瘤风险在统计学上显著增加之间的关联表明这些疾病存在共同易感性。
