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蕈样肉芽肿患者发生第二原发性血液系统和实体恶性肿瘤的风险增加:监测、流行病学和最终结果分析。

Increased risk of second primary hematologic and solid malignancies in patients with mycosis fungoides: A Surveillance, Epidemiology, and End Results analysis.

机构信息

Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.

Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

出版信息

J Am Acad Dermatol. 2020 Aug;83(2):404-411. doi: 10.1016/j.jaad.2019.07.075. Epub 2019 Jul 30.

Abstract

BACKGROUND

Mycosis fungoides (MF) is associated with increased risk of second primary hematologic malignancies, but its association with second primary solid tumors is less well characterized.

OBJECTIVE

This retrospective analysis seeks to assess the risk of being diagnosed with a second primary hematologic or solid malignancy in patients with MF.

DESIGN

We performed an analysis of patients diagnosed with MF from 2000 through 2015 in the United States cancer registries of SEER-18 (N = 6742).

RESULTS

Relative risks were estimated by using standardized incidence ratios (SIRs). Among 6742 patients, there were 511 (7.5%) second cancer events (SIR, 10.15; 95% confidence interval [CI], 9.29-11.07). These included 184 (36.0%) hematologic malignancies (SIR, 39.71; 95% CI, 34.05-46.05) and 327 (64.0%) solid tumor malignancies (SIR, 7.33; 95% CI, 6.56-8.17). Patients with MF were at increased risk for non-Hodgkin lymphoma; Hodgkin lymphoma; melanoma; and lung, female breast, prostate, colon, and renal cancers. Females were at higher risk than males (P < .05). All ethnic groups showed a statistically significant elevation in SIRs. Elevation of SIRs was observed across all stages of MF.

CONCLUSIONS AND RELEVANCE

Patients with MF are at increased risk for diagnosis of second primary malignancies and should be carefully screened for discernable signs and symptoms of second malignancies.

摘要

背景

蕈样真菌病(MF)与第二原发性血液恶性肿瘤的风险增加相关,但与第二原发性实体肿瘤的相关性尚不清楚。

目的

本回顾性分析旨在评估 MF 患者诊断为第二原发性血液或实体恶性肿瘤的风险。

设计

我们对 2000 年至 2015 年期间在美国 SEER-18 癌症登记处诊断为 MF 的患者进行了分析(N=6742)。

结果

通过使用标准化发病比(SIR)来估计相对风险。在 6742 例患者中,有 511 例(7.5%)发生了第二癌症事件(SIR 为 10.15;95%置信区间 [CI],9.29-11.07)。其中包括 184 例(36.0%)血液恶性肿瘤(SIR 为 39.71;95%CI,34.05-46.05)和 327 例(64.0%)实体瘤恶性肿瘤(SIR 为 7.33;95%CI,6.56-8.17)。MF 患者发生非霍奇金淋巴瘤、霍奇金淋巴瘤、黑色素瘤和肺癌、乳腺癌、前列腺癌、结肠癌、肾癌的风险增加。女性比男性的风险更高(P<.05)。所有种族群体的 SIR 均呈统计学显著升高。MF 的所有阶段均观察到 SIR 升高。

结论和相关性

MF 患者发生第二原发性恶性肿瘤的风险增加,应仔细筛查第二恶性肿瘤的明显症状和体征。

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