Litvinov Ivan V, Tetzlaff Michael T, Rahme Elham, Habel Youssef, Risser David R, Gangar Pamela, Jennings Michelle A, Pehr Kevin, Prieto Victor G, Sasseville Denis, Duvic Madeleine
Division of Dermatology, McGill University Health Centre, Montreal, Quebec, Canada.
Section of Dermatopathology, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer. 2015 Jun 15;121(12):1993-2003. doi: 10.1002/cncr.29301. Epub 2015 Feb 27.
Cutaneous T-cell lymphomas (CTCLs) (mycosis fungoides and its leukemic variant, Sezary syndrome) are rare malignancies. Reports of the occurrence of mycosis fungoides in married couples and families raise the possibility of an environmental trigger for this cancer. Although it has been suggested that CTCL arises from inappropriate T-cell stimulation, to the authors' knowledge no preventable trigger has been identified to date.
Using region, zip code, age, sex, and ethnicity, the authors analyzed the demographic data of 1047 patients from Texas who were seen in a CTCL clinic at The University of Texas MD Anderson Cancer Center during 2000 through 2012 (the MDACC database) and 1990 patients who were recorded in the population-based Texas Cancer Registry between 1996 and 2010. Subsequently, data from both databases were cross-analyzed and compared.
The current study findings, based on the MDACC database, documented geographic clustering of patients in 3 communities within the Houston metropolitan area, in which CTCL incidence rates were 5 to 20 times higher than the expected population rate. Analysis of the Texas Cancer Registry database defined the CTCL population rate for the state to be 5.8 cases per million individuals per year (95% confidence interval, 5.5-6.0 per million individuals per year), thus confirming the observations from the MDACC database and further highlighting additional areas of geographic clustering and regions spared from CTCL in Texas.
The current study documented geographic clustering of CTCL cases in Texas and argued for the existence of yet unknown external causes/triggers for this rare malignancy.
皮肤T细胞淋巴瘤（CTCLs）（蕈样肉芽肿及其白血病变异型，Sezary综合征）是罕见的恶性肿瘤。关于蕈样肉芽肿在已婚夫妇和家庭中发生的报道增加了这种癌症存在环境触发因素的可能性。尽管有人提出CTCL起源于不适当的T细胞刺激，但据作者所知，迄今为止尚未确定可预防的触发因素。
作者利用地区、邮政编码、年龄、性别和种族，分析了2000年至2012年期间在德克萨斯大学MD安德森癌症中心CTCL诊所就诊的1047名德克萨斯患者的人口统计学数据（MDACC数据库），以及1996年至2010年期间记录在基于人群的德克萨斯癌症登记处的1990名患者的数据。随后，对两个数据库的数据进行交叉分析和比较。
基于MDACC数据库的当前研究结果记录了休斯顿大都市地区3个社区患者的地理聚集情况，其中CTCL发病率比预期人群发病率高5至20倍。对德克萨斯癌症登记处数据库的分析确定该州CTCL人群发病率为每年每百万人口5.8例（95%置信区间，每年每百万人口5.5 - 6.0例），从而证实了MDACC数据库的观察结果，并进一步突出了德克萨斯州地理聚集的其他区域以及未受CTCL影响的区域。
当前研究记录了德克萨斯州CTCL病例的地理聚集情况，并认为这种罕见恶性肿瘤存在尚未知晓的外部原因/触发因素。
