Landgren Ola, Pfeiffer Ruth M, Stewart Laveta, Gridley Gloria, Mellemkjaer Lene, Hemminki Kari, Goldin Lynn R, Travis Lois B
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, USA.
Int J Cancer. 2007 Mar 1;120(5):1099-102. doi: 10.1002/ijc.22414.
Radiotherapy and chemotherapy are known risk factors for second cancers after lymphoma. The role of genetic influences, however, remains largely unknown. We assessed risk of second cancers associated with family history of any cancer in 41,181 patients with Hodgkin lymphoma (HL) (n = 7,476), non-Hodgkin lymphoma (NHL) (n = 25,941), or chronic lymphocytic leukemia (CLL) (n = 7,764), using a large population-based database. Family history of cancer was based on a diagnosis of any cancer in 110,862 first-degree relatives. We found increased relative risk (RR) (1.81, 95% confidence interval (CI): 1.04-3.16) of breast cancer among HL patient with positive (vs. negative) family history of cancer. Among CLL patients with positive (vs. negative) family history of cancer, we observed elevated risks of bladder (RR = 3.53, 95% CI: 1.31-9.55) and prostate cancer (RR = 2.15, 95% CI: 1.17-3.94). For NHL patients with positive (vs. negative) family history of cancer, we observed non-significantly increased risk of non-melanoma skin cancer (RR = 1.94, 95% CI: 0.86-4.38) and lung cancer (RR = 1.99, 95% CI: 0.73-5.39). Our observations suggest that genetic factors, as measured by positive family history of cancer, may be influential risk-factors for selected second tumors following lymphoproliferative disorders.
放疗和化疗是淋巴瘤后发生二次癌症的已知风险因素。然而,基因影响的作用在很大程度上仍然未知。我们使用一个大型的基于人群的数据库,评估了41181例霍奇金淋巴瘤(HL)(n = 7476)、非霍奇金淋巴瘤(NHL)(n = 25941)或慢性淋巴细胞白血病(CLL)(n = 7764)患者中与任何癌症家族史相关的二次癌症风险。癌症家族史基于110862名一级亲属中任何癌症的诊断。我们发现,癌症家族史呈阳性(与阴性相比)的HL患者患乳腺癌的相对风险(RR)增加(1.81,95%置信区间(CI):1.04 - 3.16)。在癌症家族史呈阳性(与阴性相比)的CLL患者中,我们观察到患膀胱癌(RR = 3.53,95% CI:1.31 - 9.55)和前列腺癌(RR = 2.15,95% CI:1.17 - 3.94)的风险升高。对于癌症家族史呈阳性(与阴性相比)的NHL患者,我们观察到患非黑色素瘤皮肤癌(RR = 1.94,95% CI:0.86 - 4.38)和肺癌(RR = 1.99,95% CI:0.73 - 5.39)的风险有非显著性增加。我们的观察结果表明,以癌症家族史阳性衡量的遗传因素可能是淋巴增殖性疾病后某些二次肿瘤的影响性风险因素。