癌症家族史增加霍奇金淋巴瘤患者风险
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Family Cancer History Boosts Risk for Hodgkin Lymphoma Survivors
April 1, 2008 (Reuters Health) -
Last Updated: 2008-03-31 17:21:31 -0400 (Reuters Health)
By David Douglas
NEW YORK (Reuters Health) - People who survive Hodgkin's lymphoma (HL) but have a family history of cancer are at greater risk for a second primary malignancy, according to Swedish researchers.
In the March issue of the British Journal of Cancer, Dr. Anne Andersson of Umea University Hospital and colleagues note that although there has been an increase in long-term survival after HL, life expectancy is still shorter than normal, in part due to a high risk of second malignancies.
To study the influence of a family history of cancer on survival, the researchers examined Swedish Cancer Registry data on 6946 patients treated for HL between 1965 and 1995. Altogether, 1453 HL patients (20.9%) had one or more first-degree relatives with a history of cancer.
Second malignancies developed in 696 (15%) HL patients a year or more after the original diagnosis. The risk of a second cancer increased with the number of first degree relatives with cancer.
The standardized incidence ratio (SIR) for patients with no family history of cancer was 2.06. With one relative with cancer, the SIR rose to 3.01, and with two or more, it was 3.45.
Dr. Andersson told Reuters Health that the increased risk for secondary cancers among survivors of HL "may be due to gene-environment interaction."
"A family history of cancer," she added, "could be one of the factors to consider when setting up surveillance programs for this group of patients."
Br J Cancer 2008;98:1001-1005.
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2008年4月1日
作者 David Douglas
路透社纽约讯瑞典研究者称，有恶性肿瘤家族史的霍奇金淋巴瘤患者具有更大罹患第二种原发恶性肿瘤风险。
在《不列颠癌症期刊》（British Journal of Cancer）三月刊上，于默奥大学（Umea University）医院的Anne Andersson博士和她的同事注意到，尽管霍奇金淋巴瘤患者的长期生存率在增加，他们的平均寿命仍然低于平均值，这可部分归因于他们具有较高的罹患第二种原发恶性肿瘤风险。
为研究恶性肿瘤家族史对患者生存的影响，研究者调查了瑞典癌症数据库中在1965年至1995年间接受霍奇金淋巴瘤治疗的6946位患者的数据。其中共有1453名霍奇金淋巴瘤患者（20.9%）有一个或以上的一等亲（译者注：指父母，兄弟姐妹和子女）有癌症史。
有696（15%）位患者在最初确诊淋巴瘤一年后患上第二种恶性肿瘤。患第二种癌症的风险随着一等亲患癌症的人数增加而增加。
没有癌症家族史的患者标化发病比（SIR）是2.06。如果有一个亲属患癌症，标化发病比上升到3.01，两个以上的，标化发病比为3.45。
Andersson医生告诉路透社健康部，霍奇金淋巴瘤患者增加的罹患第二种癌症风险“可能应归因于基因环境的相互作用”。
她补充说，“癌症的家族史可以成为一个考虑因素，来决定何时对这些患者建立监测计划”。
Br J Cancer 2008;98:1001-1005.
背景链接：什么是“标化发病比（SIR）”
如果在观察人群中，不知道各年龄组的发病（或死亡）率，而是利用标准人口的年龄别率与观察人群中相对年龄组人数相乘，求出年龄组预期发病（或死亡）人数的总的预期数，再与实际数相比，得出标化发病（或死亡）比[(standardized incidence ratio,SIR)或（standardized mortality ratio,SMR）]；最后乘以标准人口总发病（或总死亡）率，得出该人群的标化发病（或死亡）率。该计算法就称间接法。其计算式为：
标化发病比（SIR）=实际观察发病人数/预期发病人数
或 标化死亡比（SMR）=实际观察死亡人数/预期死亡人数 公式（20.4a）
或 标化发病率=标准人口发病率×SIR
标化死亡率=标准人口发病率×SMr 公式（20.4b）
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