美国皮肤恶性黑色素瘤与非霍奇金淋巴瘤：一项比较流行病学研究。

Department of Social Medicine, Higher Medical Institute, Plovdiv, Bulgaria.

Folia Med (Plovdiv). 1999;41(1):121-5.

Possible associations of incidence of non-Hodgkin's lymphoma (NHL) with solar UVR have been suggested (Cartwright e.a. 1994, etc.). Also, incidence for both malignant melanoma of the skin (SMM) and NHL has shown a rapid increase over the last 10-15 years worldwide. On the other hand, cyclicity in variations of incidence rates for SMM was reported (Houghton e.a. 1981, Dimitrov 1998, etc.). The present study analysed trends and variations in incidence of SMM and NHL for the USA. Annual age-standardized incidence rates for SMM and NHL (SEER database, 1973-1989) were compared. Linear and non-linear regression modeling, periodogram regression analysis and parametric tests were applied (Dimitrov e.a. 1995). The analysis denoted non-linear trends of increasing incidence for both SMM and NHL. Cyclic variations in incidence rates for SMM in US females were reported previously (Dimitrov 1993) and now were confirmed also for other strata of the population (mainly, cycles with a period T = 8 divided by 9 years, p < 0.05) as well as revealed for NHL (mainly, cycles with a period T = 8 divided by 9 years). This cyclicity was significant at 95% only for black US males (Table 1). After decycling for hypercyclicity of 20-35 years (long-term cyclic trends), however, significant high-frequency infrannual variations of 3 divided by 5 years appeared in NHL (latter cyclic variations, for instance, were observed in the sunspots index, solar UVR and stratospheric ozone). Also, significant cycles of 11-13 years appeared for white US males. Similar cyclicity of 9 divided by 11 years was observed in sunspots number over the same interval. Trends of NHL were very similar to that of SMM, as were the variations. This study might be considered a contribution to the hypothesis on possible associations of incidence for NHL with heliogeophysical phenomena.

非霍奇金淋巴瘤（NHL）的发病率与太阳紫外线辐射（UVR）之间可能存在关联，这一点已有人提出（卡特赖特等人，1994年等）。此外，在过去10至15年中，全球皮肤恶性黑色素瘤（SMM）和NHL的发病率均呈快速上升趋势。另一方面，有报告称SMM发病率存在周期性变化（霍顿等人，1981年；季米特洛夫，1998年等）。本研究分析了美国SMM和NHL发病率的趋势及变化。比较了SMM和NHL的年度年龄标准化发病率（监测、流行病学和最终结果数据库，1973 - 1989年）。应用了线性和非线性回归建模、周期图回归分析及参数检验（季米特洛夫等人，1995年）。分析表明SMM和NHL的发病率均呈非线性上升趋势。此前已报告美国女性SMM发病率的周期性变化（季米特洛夫，1993年），现在在其他人群分层中也得到了证实（主要是周期T = 8/9年，p < 0.05），NHL也有发现（主要是周期T = 8/9年）。这种周期性仅在美国黑人男性中在95%水平上具有显著性（表1）。然而，在消除20至35年的超周期性（长期周期性趋势）后，NHL出现了显著的3/5年高频次年内变化（例如，后者的周期性变化在太阳黑子指数、太阳UVR和平流层臭氧中也有观察到）。美国白人男性也出现了显著的11至13年周期。在同一时间段内，太阳黑子数量也观察到了类似的9/11年周期性。NHL的趋势与SMM非常相似，变化情况也是如此。本研究可能有助于支持关于NHL发病率与日地物理现象之间可能存在关联的假说。