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来自芬兰、挪威和瑞典的60901名非霍奇金淋巴瘤幸存者实体癌的年龄-时间风险模式。

Age-time risk patterns of solid cancers in 60 901 non-Hodgkin lymphoma survivors from Finland, Norway and Sweden.

作者信息

Lorenzo Bermejo Justo, Pukkala Eero, Johannesen Tom B, Sundquist Jan, Hemminki Kari

机构信息

Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany; Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany.

出版信息

Br J Haematol. 2014 Mar;164(5):675-83. doi: 10.1111/bjh.12684. Epub 2013 Dec 4.

Abstract

Survival after non-Hodgkin lymphoma (NHL) has increased thanks to improved treatment but NHL survivors have an increased risk of second neoplasms. The assessment of cancer risk patterns after NHL may help to quantify the late side-effects of therapy. Poisson regression was used to estimate relative risks (RRs) and absolute incidence rates for nine solid tumours based on a nationwide cohort of 60 901 NHL survivors from Finland, Norway and Sweden. Patients were diagnosed between 1980 and 2006 and developed 6815 s neoplasms. NHL patients showed an increased risk of each of the nine investigated cancer sites: prostate and pancreas (both RRs 1·28), breast (1·37), colorectum (1·48), urinary bladder (1·52), stomach and lung (both RRs 1·87), skin (melanoma 2·27) and kidney (2·56). The RRs showed a U-shaped relationship with time after NHL for all nine-second cancer types. NHL diagnosis early in life was a risk factor for the development of second cancers with the exception of melanoma, but a risk excess was even observed in patients diagnosed with NHL at age 80+ years. The present study provides accurate estimates on the adverse late effects of NHL therapy, which should guide the establishment of cancer prevention strategies in NHL survivors.

摘要

由于治疗方法的改进,非霍奇金淋巴瘤(NHL)患者的生存率有所提高,但NHL幸存者患第二种肿瘤的风险增加。评估NHL后的癌症风险模式可能有助于量化治疗的晚期副作用。基于芬兰、挪威和瑞典全国范围内60901名NHL幸存者的队列,采用泊松回归估计9种实体瘤的相对风险(RRs)和绝对发病率。患者在1980年至2006年期间被诊断,共发生6815例肿瘤。NHL患者在所调查的9个癌症部位中的每一个部位患癌风险均增加:前列腺和胰腺(RRs均为1.28)、乳腺(1.37)、结肠直肠(1.48)、膀胱(1.52)、胃和肺(RRs均为1.87)、皮肤(黑色素瘤为2.27)和肾脏(2.56)。对于所有9种第二种癌症类型,RRs与NHL后的时间呈U形关系。除黑色素瘤外,早年诊断为NHL是发生第二种癌症的危险因素,但在80岁及以上诊断为NHL的患者中甚至观察到风险增加。本研究提供了关于NHL治疗不良晚期副作用的准确估计,这应为制定NHL幸存者的癌症预防策略提供指导。

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