Groves F D, Linet M S, Travis L B, Devesa S S
Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
J Natl Cancer Inst. 2000 Aug 2;92(15):1240-51. doi: 10.1093/jnci/92.15.1240.
Clinical investigations have shown prognostic heterogeneity within the non-Hodgkin's lymphomas (NHLs) according to histology, but few descriptive studies have considered NHLs by subgroup. Our purpose is to assess the demographic patterns and any notable increases in population-based rates of different histologic subgroups of NHL.
Using data collected by the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, we calculated incidence rates for the major clinicopathologic categories of NHL by age, race, sex, geographic area, and time period.
Among the 60 057 NHL cases diagnosed during the period from 1978 through 1995, total incidence (per 100 000 person-years) was 17.1 and 11.5 among white males and females, respectively, and 12.6 and 7.4 among black males and females, respectively. However, rates for follicular NHLs were two to three times greater among whites than among blacks, with little sex variation. Blacks demonstrated much higher incidence than whites for peripheral T-cell NHL, with the incidence rates higher in males than in females. For other NHL subgroups, the incidence rates for persons less than 60 years of age were generally higher among males than among females, with little racial difference; at older ages, the rates were higher among whites than among blacks, with little sex difference. High-grade NHL was the most rapidly rising subtype, particularly among males. Follicular NHL increased more rapidly in black males than in the other three race/sex groups. Overall, the broad categories of small lymphocytic, follicular, diffuse, high-grade, and peripheral T-cell NHL emerged as distinct entities with specific age, sex, racial, temporal, and geographic variations in rates.
Findings from our large, population-based study reveal differing demographic patterns and incidence trends according to histologic group. Future descriptive and analytic investigations should evaluate NHL risks according to subtype, as defined by histology and new classification criteria.
临床研究表明，非霍奇金淋巴瘤（NHL）根据组织学表现存在预后异质性，但很少有描述性研究按亚组对NHL进行分析。我们的目的是评估不同组织学亚组NHL的人口统计学模式以及基于人群的发病率的任何显著增加情况。
利用美国国立癌症研究所监测、流行病学和最终结果计划收集的数据，我们按年龄、种族、性别、地理区域和时间段计算了NHL主要临床病理类别的发病率。
在1978年至1995年期间诊断的60057例NHL病例中，白人男性和女性的总发病率（每10万人年）分别为17.1和11.5，黑人男性和女性分别为12.6和7.4。然而，滤泡性NHL在白人中的发病率是黑人的两到三倍，性别差异不大。黑人外周T细胞NHL的发病率远高于白人，男性发病率高于女性。对于其他NHL亚组，60岁以下人群的发病率一般男性高于女性，种族差异不大；在老年人群中，白人发病率高于黑人，性别差异不大。高级别NHL是上升最快的亚型，尤其是在男性中。滤泡性NHL在黑人男性中的增长速度比其他三个种族/性别组更快。总体而言，小淋巴细胞性、滤泡性、弥漫性、高级别和外周T细胞NHL等大类呈现出不同的实体，在发病率上具有特定的年龄、性别、种族、时间和地理差异。
我们这项基于人群的大型研究结果显示，根据组织学分组存在不同的人口统计学模式和发病趋势。未来的描述性和分析性研究应根据组织学和新的分类标准所定义的亚型评估NHL风险。
