Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 550 N University Blvd., UH 4100, Indianapolis, IN, USA.
Dig Dis Sci. 2011 May;56(5):1489-95. doi: 10.1007/s10620-010-1430-z. Epub 2010 Oct 15.
Previous studies on the risk of lymphoma in inflammatory bowel disease (IBD) have yielded conflicting results. We aim to determine the incidence and risk factors for lymphoma in a large IBD population.
Patients with lymphoma were identified from a single-center IBD database. The standardized incidence ratio (SIR) of lymphoma was estimated using data from the Surveillance, Epidemiology and End Results (SEER) registry. Risk factors for lymphoma were determined by comparing cases with a matched IBD control group.
Eleven lymphomas were identified among 3,585 IBD patients during an average of 8.4 years of observation. Three patients were excluded. In the remaining eight, median age at diagnosis was 47 years and mean IBD duration was 20 years (range 7.5-45 years). The SIR for lymphoma was 1.6 [95% confidence interval (CI) 0.6-3.0], and for non-Hodgkin lymphoma (NHL), 1.5 (0.3-2.8). Three lymphoma patients (38%) received prior immunomodulators and two (25%) received biologics, versus 57% and 39% in the control group, respectively (P = 0.4). No correlation was seen with tobacco exposure, disease duration, use, or dose or duration of immunosuppressive therapy.
In this IBD cohort, risk of lymphoma was not increased compared with the general population. Risk of lymphoma was not associated with any demographic or therapy-related factors.
先前关于炎症性肠病(IBD)中淋巴瘤风险的研究结果存在矛盾。本研究旨在确定大型 IBD 人群中淋巴瘤的发病率和危险因素。
从单中心 IBD 数据库中确定淋巴瘤患者。使用来自监测、流行病学和最终结果(SEER)登记处的数据来估计淋巴瘤的标准化发病比(SIR)。通过将病例与匹配的 IBD 对照组进行比较来确定淋巴瘤的危险因素。
在平均 8.4 年的观察期间,在 3585 例 IBD 患者中发现了 11 例淋巴瘤。排除了 3 例患者。在其余的 8 例中,诊断时的中位年龄为 47 岁,IBD 病程的平均时间为 20 年(范围 7.5-45 年)。淋巴瘤的 SIR 为 1.6(95%置信区间 [CI] 0.6-3.0),非霍奇金淋巴瘤(NHL)为 1.5(0.3-2.8)。3 例淋巴瘤患者(38%)接受了先前的免疫调节剂治疗,2 例(25%)接受了生物制剂治疗,而对照组中分别为 57%和 39%(P = 0.4)。与烟草暴露、疾病持续时间、免疫抑制治疗的使用、剂量或持续时间均无相关性。
在该 IBD 队列中,与普通人群相比,淋巴瘤的风险并未增加。淋巴瘤的风险与任何人口统计学或治疗相关因素均无关。