| アブストラクト | BACKGROUND: Non-Hodgkin lymphoma (NHL) is the sixth most common cancer in the UK; approximately 35 people are diagnosed and 13 die from the disease daily. AIM: To identify the primary care clinical features of NHL and quantify their risk in symptomatic patients. DESIGN AND SETTING: Matched case-control study using Clinical Practice Research Datalink patient records. METHOD: Putative clinical features of NHL were identified in the year before diagnosis. Results were analysed using conditional logistic regression and positive predictive values (PPVs). RESULTS: A total of 4362 patients aged >/=40 years, diagnosed with NHL between 2000 and 2009, and 19 468 age, sex, and general practice-matched controls were studied. Twenty features were independently associated with NHL. The five highest risk symptoms were lymphadenopathy, odds ratio (OR) 263 (95% CI = 133 to 519), head and neck mass not described as lymphadenopathy OR 49 (95% CI = 32 to 74), other mass OR 12 (95% CI = 10 to 16), weight loss OR 3.2 (95% CI = 2.3 to 4.4), and abdominal pain OR 2.5 (95% CI = 2.1 to 2.9). Lymphadenopathy has a PPV of 13% for NHL in patients >/=60 years. Weight loss in conjunction with repeated back pain or raised gamma globulin had PPVs >2%. CONCLUSION: Unexplained lymphadenopathy in patients aged >/=60 years produces a very high risk of NHL in primary care. These patients warrant urgent investigation, potentially sooner than 6 weeks from initial presentation where the GP is particularly concerned. |
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| ジャーナル名 | The British journal of general practice : the journal of the Royal College of General Practitioners |
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| 投稿日 | 2015/04/29 |
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| 投稿者 | Shephard, Elizabeth A; Neal, Richard D; Rose, Peter W; Walter, Fiona M; Hamilton, William T |
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| 組織名 | University of Exeter Medical School, Exeter.;North Wales Centre for Primary Care Research, Bangor University, Wrexham.;Department of Primary Care Health Sciences, University of Oxford, Oxford.;Department of Public Health and Primary Care, University of Cambridge, Cambridge. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25918332/ |
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