EVIDENCE OF AN ASSOCIATION BETWEEN NON-HODGKINS-LYMPHOMA AND SKIN-CANCER
EVIDENCE OF AN ASSOCIATION BETWEEN NON-HODGKINS-LYMPHOMA AND SKIN-CANCER
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DOI：
10.1136/bmj.310.6993.1491
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发表时间：
1995-06-10
影响因子：
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通讯作者：
MELBYE, M
中科院分区：
文献类型：
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作者：
ADAMI, J;FRISCH, M;MELBYE, M
研究暴露于紫外线与全球非霍奇金淋巴瘤流行性增加之间的可能联系。由于紫外线是已知的，会导致皮肤癌，非霍奇金淋巴瘤和皮肤癌之间的关联进行了study. Design-恶性黑色素瘤或鳞状细胞皮肤癌的第二次发生在队列的患者无论是非霍奇金淋巴瘤或慢性淋巴细胞白血病，反之亦然，进行了研究。随后癌症的预期数量通过性别、年龄和特定时期的国家发病率乘以队列中观察到的人年来计算。设置-丹麦（1943-89）和瑞典（1958-89）。受试者-在全国癌症登记处确定的四个基于人群的队列（34641人患有非霍奇金淋巴瘤，17400人患有慢性淋巴细胞白血病，34989人患有恶性黑色素瘤，25980人患有鳞状细胞皮肤癌）。分析的总人数为562085人年。主要结果测量-观察到的癌症与预期癌症的比率结果：患鳞状细胞皮肤癌的相对危险度为5.5在非霍奇金淋巴瘤患者中为8.6（95%置信区间4.6至6.6），在慢性淋巴细胞白血病患者中为8.6（7.2至10.3）。在超过IS年的随访中，相对风险仍然很高。恶性黑色素瘤的相对风险在非霍奇金淋巴瘤患者中为2.4（1.8至3.2），在慢性淋巴细胞白血病患者中为3.1（2.1至4.4）。在诊断出鳞状细胞皮肤癌后，患非霍奇金淋巴瘤和慢性淋巴细胞白血病的风险增加了两倍。相比之下，在每个队列中，排除皮肤和淋巴组织增生性恶性肿瘤的一般癌症风险接近预期。结论-非霍奇金淋巴瘤和皮肤癌的发生密切相关;这支持了近几十年来暴露于紫外线的长期增加可能导致非霍奇金淋巴瘤发病率增加的假设
Objective-To investigate a possible Link between exposure to ultraviolet light and the almost epidemic increase in non-Hodgkin's lymphoma worldwide. Because ultraviolet light is known to cause skin cancers, the association between non-Hodgkin's lymphoma and skin cancer was studied.Design-Secondary occurrence of either malignant melanoma or squamous cell skin cancer in cohorts of patients with a first diagnosis of either non-Hodgkin's lymphoma or chronic lymphocytic leukaemia, and vice versa, were studied. Expected numbers of subsequent cancers were calculated by sex, age, and period specific national incidence rates multiplied by the person years under observation in the cohorts.Setting-Denmark (1943-89) and Sweden (1958-89).Subjects-Four population based cohorts identified in the nationwide cancer registries (34641 people with non-Hodgkin's lymphoma, 17400 with chronic lymphocytic leukaemia, 34989 with malignant melanoma, 25980 with squamous cell skin cancer). A total of 562085 person years were accrued for the analysis.Main outcome measures-The ratios of observed to expected cancers (the standardised incidence ratio) served as a measure of the relative risk.Results-The relative risk for developing squamous cell skin cancer was 5.5 (95% confidence interval 4.6 to 6.6) among patients with non-Hodgkin's lymphoma and 8.6 (7.2 to 10.3) among patients with chronic lymphocytic leukaemia. The relative risks remained high over more than IS years of follow up. Relative risks for malignant melanoma were 2.4 (1.8 to 3.2) for patients with non-Hodgkin's lymphoma and 3.1 (2.1 to 4.4) for patients with chronic lymphocytic leukaemia. After aquamous cell skin cancer had been diagnosed there was a twofold excess risk for non-Hodgkin's lymphoma and chronic lymphocytic leukaemia. By contrast, in each of the cohorts the general cancer risks excluding skin and lymphoproliferative malignancies were close to the expected.Conclusions-The occurrence of non-Hodgkin's lymphoma and skin cancer are strongly associated; this supports the hypothesis that the secular increase in exposure to ultraviolet light may have contributed to the increasing incidence of non-Hodgkin's lymphoma in recent decades