Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Bldg. EPS/Room 7012, Bethesda, 20892-7236, USA.
Haematologica. 2009 Oct;94(10):1460-4. doi: 10.3324/haematol.2008.004721.
We investigated whether a previous diagnosis of non-melanoma skin cancer among chronic lymphocytic leukemia patients is a predictor of poor outcome. Using the Swedish Cancer Registry, we conducted a population-based study to evaluate the survival patterns among chronic lymphocytic leukemia patients with and without non-melanoma skin cancer. Cox proportional hazards regression models were used and Kaplan-Meier curves were constructed. Of a total of 12,041 chronic lymphocytic leukemia cases identified, 236 cases, including 111 squamous cell cancer, had a prior history of non-melanoma skin cancer. Chronic lymphocytic leukemia patients with a prior history of non-melanoma skin cancer had a 1.29-fold (95% CI 1.10-1.52; p=0.0024) increased risk of dying; and those with a history of squamous cell cancer had a further elevated 1.86-fold (95% CI 1.46-2.36; p<0.0001) risk of dying. Kaplan-Meier plots showed that patients with a history of non-melanoma skin cancer, particularly those with squamous cell cancer, had significantly poorer survival than chronic lymphocytic leukemia patients without non-melanoma skin cancer (p<0.0001; log-rank test). Non-melanoma skin cancer may be a novel clinical predictor of worse chronic lymphocytic leukemia outcome.
我们研究了慢性淋巴细胞白血病患者中是否存在非黑色素瘤皮肤癌病史是否是预后不良的预测指标。我们利用瑞典癌症登记处，开展了一项基于人群的研究，以评估患有和不患有非黑色素瘤皮肤癌的慢性淋巴细胞白血病患者的生存模式。使用 Cox 比例风险回归模型和 Kaplan-Meier 曲线进行构建。在总共确定的 12041 例慢性淋巴细胞白血病病例中，有 236 例（包括 111 例鳞状细胞癌）有非黑色素瘤皮肤癌的既往病史。有非黑色素瘤皮肤癌既往病史的慢性淋巴细胞白血病患者的死亡风险增加了 1.29 倍（95%CI 1.10-1.52；p=0.0024）；有鳞状细胞癌病史的患者的死亡风险进一步升高了 1.86 倍（95%CI 1.46-2.36；p<0.0001）。Kaplan-Meier 图显示，有非黑色素瘤皮肤癌病史的患者，特别是有鳞状细胞癌病史的患者，其生存情况明显比没有非黑色素瘤皮肤癌的慢性淋巴细胞白血病患者差（p<0.0001；对数秩检验）。非黑色素瘤皮肤癌可能是慢性淋巴细胞白血病预后不良的一个新的临床预测指标。
