Risk of non-Hodgkin lymphoma in celiac disease
Risk of non-Hodgkin lymphoma in celiac disease
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DOI：
10.1001/jama.287.11.1413
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发表时间：
2002-03-20
影响因子：
120.7
通讯作者：
Corazza, GR
中科院分区：
文献类型：
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作者：
Catassi, C;Fabiani, E;Corazza, GR
背景乳糜泻是最常见的终身疾病之一。非霍奇金淋巴瘤是乳糜泻的一种可能并发症，可能导致大部分淋巴瘤病例。目的量化与乳糜泻相关的任何原发部位发生非霍奇金淋巴瘤的风险。设计和设置 1996 年 1 月至 1999 年 12 月在意大利各地进行的多中心病例对照研究。患者病例年龄超过 20 岁（中位年龄 57 岁；范围， 20-92岁）患有任何原发部位和组织学类型的非霍奇金淋巴瘤，并在诊断时被招募。对照是来自普通人群的健康成年人（2739 名男性和 2981 名女性）。主要结果测量 A 类血清抗内膜抗体检测结果呈阳性。结果 653 名淋巴瘤患者中有 6 名（0.92%）被诊断为乳糜泻。在这 6 例病例中，3 例为 B 细胞来源，3 例为 T 细胞来源。 6 例中有 4 例患有主要位于肠道的淋巴瘤。在对照组中，24 人（0.42%）患有乳糜泻。与乳糜泻相关的任何原发部位的非霍奇金淋巴瘤的比值比（根据年龄和性别进行调整）分别为 3.1（95% 置信区间 [CI]，1.3-7.6）、肠道淋巴瘤为 16.9（95% CI，7.4-38.7）、T 细胞淋巴瘤为 19.2（95% CI，7.9-46.6）。根据年龄和性别进行调整后，总体人群患非霍奇金淋巴瘤的风险为 0.63%（95% CI，-0.12% 至 1.37%）。 结论 乳糜泻与非霍奇金淋巴瘤风险增加相关，尤其是 T 细胞型且主要位于肠道的非霍奇金淋巴瘤。然而，这种关联并不代表有足够大的风险来证明对乳糜泻进行早期大规模筛查是合理的。
Context Celiac disease is one of the most common lifelong disorders. Non-Hodgkin lymphoma is a possible complication of celiac disease and may lead to a large portion of lyphoma cases.Objective To quantify the risk for developing non-Hodgkin lymphoma of any primary site associated with celiac disease.Design and Setting Multicenter, case-control study conducted between January 1996 and December 1999 throughout Italy.Patients Cases were older than 20 years (median, 57; range, 20-92 years) with non Hodgkin lymphoma of any primary site and histological type and were recruited at the time of the diagnosis. Controls were healthy adults (2739 men and 2981 women) from the general population.Main Outcome Measure Positive test result for class A serum antiendomysial antibody.Results Celiac disease was diagnosed in 6 (0.92%) of 653 patients with lymphoma. Of the 6 cases, 3 were of B-cell and 3 were of T-cell origin. Four of 6 cases had lymphoma primarily located in the gut. In the control group, 24 (0.42%) had celiac disease. The odds ratio (adjusted for age and sex) for non-Hodgkin lymphoma of any primary site associated with celiac disease was 3.1 (95% confidence interval [CI], 1.3-7.6), 16.9 (95% CI, 7.4-38.7) for gut lymphoma, and 19.2 (95% CI, 7.9-46.6) for T-cell lymphoma, respectively. The risk for non-Hodgkin lymphoma for the overall population, which was adjusted for age and sex, was 0.63% (95% CI, -0.12% to 1.37%).Conclusion Celiac disease is associated with an increased risk for non-Hodgkin lymphoma, especially of T-cell type and primarily localized in the gut. However, the association does not represent a great enough risk to justify early mass screening for celiac disease.