The risk of lymphoma in patients with psoriasis
The risk of lymphoma in patients with psoriasis
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DOI：
10.1038/sj.jid.5700410
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发表时间：
2006-10-01
影响因子：
6.5
通讯作者：
Troxel, Andrea B.
中科院分区：
文献类型：
--
作者：
Gelfand, Joel M.;Shin, Daniel B.;Troxel, Andrea B.
银屑病是一种常见的慢性炎症性疾病。由于其病理生理学、治疗或这些因素的组合，银屑病已被假设与淋巴瘤风险增加相关。我们使用全科医学研究数据库进行了一项关于银屑病患者淋巴瘤风险的大型人群队列研究。我们确定了153，197例银屑病患者和765，950例相应的无银屑病受试者。接受与广泛疾病一致的全身治疗的银屑病患者被归类为重度（N= 3，994），未接受全身治疗的患者被归类为轻度（N= 149，203）。使用考克斯比例风险模型对分析进行年龄、性别和人-时间调整。对于轻度和重度银屑病患者，淋巴瘤及其亚型各自调整后的相对风险如下：所有淋巴瘤1.34（1.16，1.54）和1.59（0.88，2.89）;非霍奇金淋巴瘤1.15（0.97，1.37）和0.73霍奇金淋巴瘤（HL）1.42（1.00，2.02）和3.18（1.01，9.97）;皮肤T细胞淋巴瘤（TCL）4.10（2.70，6.23）和10.75（3.89，29.76）。银屑病与淋巴瘤风险增加有关。HL和CTCL的相关性最强。银屑病引起淋巴瘤的额外风险为每年7.9/100，000例银屑病患者。虽然银屑病患者患淋巴瘤的相对风险增加，但由于淋巴瘤是一种罕见疾病，且相关性程度适中，因此银屑病的绝对风险较低。
Psoriasis is a common, chronic, inflammatory disease. Psoriasis has been hypothesized to be associated with an increased risk of lymphoma due to its pathophysiology, its treatments, or a combination of these factors. We performed a large population-based cohort study of the risk of lymphoma in psoriasis patients using the General Practice Research Database. We identified 153,197 patients with psoriasis and 765,950 corresponding subjects without psoriasis. Psoriasis patients who received a systemic treatment consistent with extensive disease were classified as severe (N=3,994) and those who did not receive systemic therapies were classified as mild (N=149,203). The analyses were adjusted for age, gender, and person-time using a Cox proportional hazards model. For mild and severe psoriasis patients, the respective adjusted relative risks for lymphoma and its subtypes were as follows: all lymphoma 1.34 (1.16, 1.54) and 1.59 (0.88, 2.89); non-Hodgkin's lymphoma 1.15 (0.97, 1.37) and 0.73 (0.28, 1.96); Hodgkin's lymphoma (HL) 1.42 (1.00, 2.02) and 3.18 (1.01, 9.97); cutaneous T-cell lymphoma (TCL) 4.10 (2.70, 6.23) and 10.75 (3.89, 29.76). Psoriasis is associated with an increased risk of lymphoma. The association is strongest for HL and CTCL. The excess risk of lymphoma attributed to psoriasis was 7.9/100,000 psoriasis patients per year. Although patients with psoriasis have an increased relative risk of lymphoma, the absolute risk attributable to psoriasis is low given that lymphoma is a rare disease and the magnitude of association is modest.