蕈样肉芽肿和塞扎里综合征患者的继发性淋巴瘤及其他恶性肿瘤：基于人群和临床队列的证据

Second lymphomas and other malignant neoplasms in patients with mycosis fungoides and Sezary syndrome: evidence from population-based and clinical cohorts.

作者信息

Huang Kathie P, Weinstock Martin A, Clarke Christina A, McMillan Alex, Hoppe Richard T, Kim Youn H

机构信息

Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA.

出版信息

Arch Dermatol. 2007 Jan;143(1):45-50. doi: 10.1001/archderm.143.1.45.

DOI:10.1001/archderm.143.1.45

PMID:17224541

Abstract

OBJECTIVE

To assess risks for developing second malignancies in patients with mycosis fungoides or Sézary syndrome.

DESIGN

Retrospective study of 2 cohorts.

SETTING

Nine population-based US cancer registries that constitute the Surveillance, Epidemiology, and End Results Program (SEER-9), and Stanford University referral center cohort of patients with cutaneous lymphoma. Patients with mycosis fungoides or Sézary syndrome from the SEER-9 registry diagnosed and followed up from 1984 through 2001 and from the Stanford University cohort diagnosed and followed up from 1973 through 2001.

MAIN OUTCOME MEASURES

Relative risk was estimated using the standardized incidence ratio (SIR). The expected cancer incidence for both cohorts was calculated using age-, sex-, race-, and calendar year-specific SEER-9 incidence rates for the general population. Nonmelanoma skin cancers were excluded because these cancers are not routinely reported by the SEER database.

RESULTS

In the SEER-9 cohort (n = 1798), there were 197 second instances of cancer (SIR = 1.32; 95% confidence interval [CI], 1.15-1.52) at all sites. Significantly elevated risk (P<.01) was observed for Hodgkin disease (6 cases; SIR = 17.14; 95% CI, 6.25-37.26) and non-Hodgkin lymphoma (27 cases; SIR = 5.08; 95% CI, 3.34-7.38). Elevated risk (P<.05) was also observed for melanoma (10 cases; SIR = 2.60; 95% CI, 1.25-4.79), and urinary cancer (21 cases; SIR = 1.74; 95% CI, 1.08-2.66). In the Stanford University cohort (n = 429), there were 37 second instances of cancer (SIR = 1.04; 95% CI, 0.76-1.44). Elevated risk (P<.01) was observed for Hodgkin disease (3 cases; SIR = 27.27; 95% CI, 5.35-77.54). Elevated risk (P<.05) was also observed for biliary cancer (2 cases; SIR = 11.76; 95% CI, 1.51-42.02).

CONCLUSION

Updated SEER (population based) and Stanford (clinic based) data confirm the generalizability of earlier findings of increased risk of lymphoma in patients with mycosis fungoides or Sézary syndrome.

摘要

目的

评估蕈样肉芽肿或塞扎里综合征患者发生第二原发性恶性肿瘤的风险。

设计

对两个队列进行回顾性研究。

设置

美国九个基于人群的癌症登记处，构成监测、流行病学和最终结果计划（SEER - 9），以及斯坦福大学皮肤淋巴瘤患者转诊中心队列。来自SEER - 9登记处的蕈样肉芽肿或塞扎里综合征患者于1984年至2001年进行诊断和随访，来自斯坦福大学队列的患者于1973年至2001年进行诊断和随访。

主要观察指标

使用标准化发病比（SIR）估计相对风险。两个队列的预期癌症发病率均使用一般人群按年龄、性别、种族和日历年份特定的SEER - 9发病率计算。非黑色素瘤皮肤癌被排除，因为SEER数据库通常不报告这些癌症。

结果

在SEER - 9队列（n = 1798）中，所有部位共出现197例第二原发性癌症（SIR = 1.32；95%置信区间[CI]，1.15 - 1.52）。霍奇金病（6例；SIR = 17.14；95% CI，6.25 - 37.26）和非霍奇金淋巴瘤（27例；SIR = 5.08；95% CI，3.34 - 7.38）的风险显著升高（P <.01）。黑色素瘤（10例；SIR = 2.60；95% CI，1.25 - 4.79）和泌尿系统癌症（21例；SIR = 1.74；95% CI，1.08 - 2.66）的风险也升高（P <.05）。在斯坦福大学队列（n = 429）中，有37例第二原发性癌症（SIR = 1.04；95% CI，0.76 - 1.44）。霍奇金病（3例；SIR = 27.27；95% CI，5.35 - 77.54）的风险升高（P <.01）。胆管癌（2例；SIR = 11.76；95% CI，1.51 - 42.02）的风险也升高（P <.05）。