Biggar R J, Rabkin C S
National Cancer Institute, Bethesda, Maryland.
Curr Opin Oncol. 1992 Oct;4(5):883-93. doi: 10.1097/00001622-199210000-00011.
Approximately 3% of acquired immunodeficiency syndrome cases present with non-Hodgkin's lymphoma. By 6 to 8 years after human immunodeficiency virus infection, lymphoma risk is elevated 100-fold, and the risk approaches 1% per year following acquired immunodeficiency syndrome diagnosis. The proportions presenting as lymphoma differ by age, sex, and race, with relative rates being higher in older persons, males, and whites. The differences are similar in magnitude and direction to those seen in non-human immunodeficiency virus-infected persons and account for the variation by risk group. The relative risk of high-grade lymphoma is greatest, but significant increases are also seen for some intermediate-grade tumors. At diagnosis, persons with Burkitt's lymphoma, more common in children, have significantly higher average CD4 counts than those with immunoblastic tumors. Human immunodeficiency virus-associated lymphoma risk is probably related to dysregulation of the immune system leading to uncontrolled proliferation of transformed cell clones and subsequent genetic accidents. Environmental factors are unlikely to be important. By 1994, 10% of all lymphomas will be human immunodeficiency virus related, but this proportion will increase in the future. New approaches to the therapy of lymphoma are needed for this tumor, which we can neither prevent nor adequately treat.
约3%的获得性免疫缺陷综合征病例会出现非霍奇金淋巴瘤。在人类免疫缺陷病毒感染后的6至8年，淋巴瘤风险升高100倍，且在获得性免疫缺陷综合征诊断后，每年的风险接近1%。以淋巴瘤形式出现的比例因年龄、性别和种族而异，老年人、男性和白人的相对发病率较高。这些差异在幅度和方向上与未感染人类免疫缺陷病毒的人相似，且解释了不同风险组之间的差异。高级别淋巴瘤的相对风险最大，但一些中级别肿瘤的风险也有显著增加。在诊断时，儿童中更常见的伯基特淋巴瘤患者的平均CD4计数显著高于免疫母细胞性肿瘤患者。人类免疫缺陷病毒相关淋巴瘤风险可能与免疫系统失调有关，导致转化细胞克隆不受控制地增殖以及随后的基因意外。环境因素不太可能起重要作用。到1994年，所有淋巴瘤中有10%将与人类免疫缺陷病毒相关，但这一比例未来还会增加。对于这种我们既无法预防也无法充分治疗的肿瘤，需要新的淋巴瘤治疗方法。
