韩国炎症性肠病患者淋巴瘤的风险及临床特征：一项多中心研究
Risk and clinical characteristics of lymphoma in Korean patients with inflammatory bowel diseases: a multicenter study.
作者信息
Park Soo-Kyung, Ye Byong Duk, Lee Changhyun, Im Jong Pil, Kim Young-Ho, Kim Seon-Ok, Byeon Jeong-Sik, Myung Seung-Jae, Yang Suk-Kyun, Kim Jin-Ho
机构信息
Departments of *Gastroenterology †Inflammatory Bowel Disease Center ∥Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine ‡Department of Internal Medicine, Division of Gastroenterology, Seoul National University College of Medicine §Department of Medicine, Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
出版信息
J Clin Gastroenterol. 2015 Feb;49(2):e11-6. doi: 10.1097/MCG.0000000000000129.
BACKGROUND AND AIMS
Studies of lymphoma risk in Western inflammatory bowel disease (IBD) patients show conflicting results; however, none have examined the lymphoma risk and clinical characteristics of Asian IBD patients.
METHODS
Patients with lymphoma were identified in an IBD database from 3 tertiary referral centers in Seoul, Korea. The standardized incidence ratio (SIR) of lymphoma was estimated using data from the Korea Central Cancer Registry of the National Cancer Center. The risk of lymphoma in relation to specific medications was also explored.
RESULTS
Seven cases of lymphoma (0.1%) were identified in 6585 IBD patients. The median age at lymphoma diagnosis was 43 years (range, 33 to 70 y) and the median duration of IBD at lymphoma diagnosis was 96.1 months (range, 15.1 to 171.6 mo). Three patients had underlying ulcerative colitis and 4 had Crohn's disease (CD). Non-Hodgkin lymphoma was diagnosed in 5 patients (71.4%) and Hodgkin disease (HD) in 2 patients (28.6%). The SIR of lymphoma was 2.03 [95% confidence interval (CI), 0.81-4.18] in the entire IBD patients. Both the SIR of lymphoma in CD patients (9.31; 95% CI, 1.13-33.62) and the SIR of HD (13.16; 95% CI, 1.59-47.53) in IBD patients were increased. The SIR of lymphoma in patients who were exposed to thiopurines was 5.93 (95% CI, 1.61-15.18).
CONCLUSIONS
The risk of lymphoma in CD patients and the risk of HD in IBD patients seem to be increased in Korea. Thiopurine may be related with the risk of lymphoma in Korean IBD patients.
背景与目的
对西方炎症性肠病（IBD）患者淋巴瘤风险的研究结果相互矛盾；然而，尚无研究探讨亚洲IBD患者的淋巴瘤风险及临床特征。
方法
在韩国首尔3家三级转诊中心的IBD数据库中识别出淋巴瘤患者。使用国家癌症中心韩国中央癌症登记处的数据估算淋巴瘤的标准化发病比（SIR）。还探讨了与特定药物相关的淋巴瘤风险。
结果
在6585例IBD患者中识别出7例淋巴瘤（0.1%）。淋巴瘤诊断时的中位年龄为43岁（范围33至70岁），淋巴瘤诊断时IBD的中位病程为96.1个月（范围15.1至171.6个月）。3例患者患有溃疡性结肠炎，4例患有克罗恩病（CD）。5例患者（71.4%）诊断为非霍奇金淋巴瘤，2例患者（28.6%）诊断为霍奇金病（HD）。整个IBD患者中淋巴瘤的SIR为2.03 [95%置信区间（CI），0.81 - 4.18]。CD患者中淋巴瘤的SIR（9.31；95% CI，1.13 - 33.62）以及IBD患者中HD的SIR（13.16；95% CI，1.59 - 47.53）均升高。接受硫唑嘌呤治疗的患者中淋巴瘤的SIR为5.93（95% CI，1.61 - 15.18）。
结论
在韩国，CD患者的淋巴瘤风险以及IBD患者的HD风险似乎有所增加。硫唑嘌呤可能与韩国IBD患者的淋巴瘤风险有关。
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