Gurney Karen A, Cartwright Ray A
Leukaemia Research Fund Centre for Clinical Epidemiology at Leeds University, Institute of Epidemiology, Margaret Smith Building, 30 Hyde Terrace, LS2 9LN, UK.
Hematol J. 2002;3(2):95-104. doi: 10.1038/sj.thj.6200154.
The incidence of non-Hodgkin lymphoma (NHL) arising from extranodal tissue has been reported to be increasing in Western countries and yet the epidemiology of this heterogeneous disease has been poorly described.
: Cases of extranodal NHL were reported to a specialist population-based registry covering neoplastic hematological conditions in parts of England and Wales from 1986 to 1993.
Nearly one third of all NHL, 3556 cases, were extranodal in origin giving a world standardised incidence rate of 1.9/10(5) per year. The most common sites were the skin, stomach and small intestine and high-grade malignancies were predominant. An excess in male incidence was observed for extranodal NHL overall, at all ages, and for most sites. Time-trend analyses indicated significant increases in incidence for all extranodal NHL and NHL of the gastrointestinal tract, skin, central nervous system and male genital organs. Incidence rates increased proportionally more for middle-aged persons, especially females, and for skin lymphomas excluding mycosis fungoides and Sezary disease.
These results suggest that the rise in incidence of extranodal NHL may be due, at least in part, to an increase specifically in B-cell skin lymphomas and that particular environmental factors such as sunlight might be involved rather than the increases being the results of improvements in diagnostic practices.
据报道，西方国家结外组织来源的非霍奇金淋巴瘤（NHL）发病率呈上升趋势，但这种异质性疾病的流行病学情况却鲜有描述。
1986年至1993年期间，将结外NHL病例报告给一个基于人群的专科登记处，该登记处涵盖英格兰和威尔士部分地区的肿瘤血液疾病。
所有NHL病例中近三分之一（3556例）起源于结外，世界标准化发病率为每年1.9/10⁵。最常见的部位是皮肤、胃和小肠，高级别恶性肿瘤占主导。总体而言，各年龄段以及大多数部位的结外NHL男性发病率均偏高。时间趋势分析表明，所有结外NHL以及胃肠道、皮肤、中枢神经系统和男性生殖器官的NHL发病率均显著上升。中年人群，尤其是女性，以及除蕈样霉菌病和塞扎里病之外的皮肤淋巴瘤发病率上升幅度更大。
这些结果表明，结外NHL发病率的上升可能至少部分归因于B细胞皮肤淋巴瘤的特异性增加，可能涉及特定环境因素，如阳光，而非诊断方法改进导致的发病率上升。
