Gridley G, Klippel J H, Hoover R N, Fraumeni J F
National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Ann Intern Med. 1994 Jan 1;120(1):35-9. doi: 10.7326/0003-4819-120-1-199401010-00006.
To estimate the incidence of cancer (especially lymphoproliferative malignancies) in patients with the Felty syndrome.
A retrospective cohort study.
A computerized database of all discharge records for 1969 to 1990 from a Veterans Affairs hospital.
906 men with a discharge diagnosis of the Felty syndrome.
Standardized incidence ratios (SIR) (ratios of observed-to-expected events) estimated the risk for specific cancers. Hospital records confirmed the diagnoses of the Felty syndrome and cancer.
We observed a twofold increase in total cancer incidence (137 patients; SIR = 2.09; 95% CI, 1.8 to 2.5). The risk for non-Hodgkin lymphoma (19 patients; SIR = 12.8, CI, 7.7 to 20.0) was much greater than the twofold increase in risk for lymphoma generally reported for rheumatoid arthritis. The risk for leukemia was increased but only within 5 years of the first hospitalization for the Felty syndrome, (13 patients; SIR = 7.67; CI, 4.1 to 13.1).
The increased risk for non-Hodgkin lymphoma after the Felty syndrome in our study is similar to the risk associated with the Sjögren syndrome and may reflect similar immunostimulatory mechanisms.
评估费尔蒂综合征患者的癌症(尤其是淋巴增殖性恶性肿瘤)发病率。
一项回顾性队列研究。
一个包含1969年至1990年某退伍军人事务医院所有出院记录的计算机数据库。
906名出院诊断为费尔蒂综合征的男性。
标准化发病比(SIR)(观察到的事件与预期事件的比率)用于评估特定癌症的风险。医院记录证实了费尔蒂综合征和癌症的诊断。
我们观察到癌症总发病率增加了两倍(137例患者;SIR = 2.09;95%置信区间,1.8至2.5)。非霍奇金淋巴瘤的风险(19例患者;SIR = 12.8,置信区间,7.7至20.0)远高于类风湿关节炎通常报道的淋巴瘤风险增加两倍。白血病风险增加,但仅在首次因费尔蒂综合征住院后的5年内(13例患者;SIR = 7.67;置信区间,4.1至13.1)。
在我们的研究中,费尔蒂综合征后非霍奇金淋巴瘤风险增加与干燥综合征相关风险相似,可能反映了相似的免疫刺激机制。