AlShemmari Salem H, Ameen Reem M, Sajnani Kamlesh P
Department of Medicine, Kuwait University, Jabriya, Kuwait.
Hematology. 2008 Jun;13(3):163-9. doi: 10.1179/102453308X316149.
The incidence of extranodal non-Hodgkin's lymphoma (NHL) is increasing worldwide. The epidemiology of NHL in the Middle East is largely unknown.
We evaluated all cases of NHL diagnosed at our institutions between 1998 and 2003 according to the site of presentation and their classification into primary nodal and primary extranodal NHL using strict criteria. Extranodal cases and early stage primary nodal cases were compared in terms of clinical characteristics and treatment outcomes.
There were 422 NHL cases diagnosed between January 1998 and December 2003, among which 97 cases (23%) were primary nodal, 132 (31%) were early nodal, and 193 (46%) were disseminated primary nodal. In general, there was a male preponderance of primary nodal cases (63% versus 44%; p=0.007). There was a higher prevalence of primary nodal cases in Arabs than in Asians: Kuwaiti Arabs, 50%; other Arabs, 46%; and Asians, 11%. There was a different distribution of histologic subtypes between primary nodal and extranodal NHL (p=0.001). The most common histologic subtype among extranodal cases was diffuse large B cell lymphoma, which accounted for 71% (69) of cases. The most common anatomic site involved was the gastrointestinal tract, which accounted for 45% of all cases. The difference in event-free survival between nodal and extranodal low-grade NHL was not statistically significant (p=0.17). Primary nodal high-grade lymphomas show an overall survival than the primary extranodal disease (p=0.003).
We conclude that extranodal NHL is common among patients of Arabic descent. Diffuse large B cell lymphoma is the most common histologic subtype and often involves the gastrointestinal tract. Patients with aggressive primary extranodal NHL have lower overall survival than patients with early primary nodal disease.
结外非霍奇金淋巴瘤（NHL）的发病率在全球范围内呈上升趋势。中东地区NHL的流行病学情况在很大程度上尚不明确。
我们根据就诊部位以及使用严格标准将其分类为原发性淋巴结型和原发性结外型NHL，对1998年至2003年间在我们机构诊断的所有NHL病例进行了评估。比较了结外病例和早期原发性淋巴结病例的临床特征及治疗结果。
1998年1月至2003年12月期间共诊断出422例NHL病例，其中97例（23%）为原发性淋巴结型，132例（31%）为早期淋巴结型，193例（46%）为播散性原发性淋巴结型。总体而言，原发性淋巴结型病例中男性占优势（63%对44%；p = 0.0．007）。阿拉伯人中原发性淋巴结型病例的患病率高于亚洲人：科威特阿拉伯人，50%；其他阿拉伯人，46%；亚洲人，11%。原发性淋巴结型和结外型NHL的组织学亚型分布不同（p = 0.001）。结外病例中最常见的组织学亚型是弥漫性大B细胞淋巴瘤，占病例的71%（69例）。最常累及的解剖部位是胃肠道，占所有病例的45%。淋巴结型和结外型低级别NHL的无事件生存率差异无统计学意义（p = 0.17）。原发性淋巴结型高级别淋巴瘤的总生存率高于原发性结外疾病（p = 0.003）。
我们得出结论，结外NHL在阿拉伯裔患者中很常见。弥漫性大B细胞淋巴瘤是最常见的组织学亚型，且常累及胃肠道。侵袭性原发性结外NHL患者的总生存率低于早期原发性淋巴结疾病患者。
