School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Cancer Epidemiol. 2009 Nov;33(5):337-46. doi: 10.1016/j.canep.2009.09.006. Epub 2009 Oct 22.
Extranodal non-Hodgkin lymphoma (NHL) accounts for much of the increase in NHL incidence in the past three decades in the United States, but its descriptive epidemiology is scarce in the literature.
Incidence data for the years 1999-2003 were from 38 population-based cancer registries, covering 82% of US population. We grouped anatomic sites of extranodal NHLs according to the Surveillance, Epidemiology, and End Results (SEER) site recodes, and histology subtypes according to the nested classification of lymphoid neoplasms developed by the Pathology Working Group of the International Lymphoma Epidemiology Consortium.
Blacks and Asians/Pacific Islanders (APIs) experienced incidence rates about the same as or lower than whites' for B-cell extranodal NHL as a whole and most of its histologic subtypes. The significant exceptions are: API men had a 40% higher rate of marginal zone lymphoma (MZL) than white men, and API women had a 12% higher rate of diffuse large B-cell lymphoma (DLBCL) than white women. The rates of all T-cell extranodal NHLs combined and peripheral T-cell lymphoma (PTCL) among black women exceeded those of white women by 46% and 18%, respectively. Blacks also had higher rates of mycosis fungoides (MF) than whites (28% higher for men and 99% higher for women). The most common sites of extranodal NHL are stomach, skin, and oral cavity and pharynx. Compared with whites, blacks had either lower or similar incidence of NHL for all sites except skin for women while APIs had higher rates of NHL of the stomach, nose/nasal cavity/middle ear, colorectum (women only), and brain (men only). Age was associated with race- and sex-specific differences in histology-specific incidence rates.
While blacks and APIs had lower or similar overall incidence rates for extranodal NHL, they experienced excessive rates in some subtypes. Blacks had higher rates of the two most common types of T-cell extranodal NHL and APIs had higher rate of the two common types of B-cell types than whites. Distinct race-specific patterns in histology- and site-specific incidence of extranodal NHL may implicate racial differences in risk factor exposure and/or genetic predisposition.
在美国，过去三十年来，结外非霍奇金淋巴瘤（NHL）的发病率增长了很多，但有关其描述性流行病学的文献却很少。
1999-2003 年的数据来自 38 个人群癌症登记处，覆盖了美国 82%的人口。我们根据监测、流行病学和最终结果（SEER）部位重新编码，将结外 NHL 的解剖部位进行分组，并根据国际淋巴瘤流行病学联盟病理学工作组开发的淋巴肿瘤嵌套分类对组织学亚型进行分组。
黑人和亚洲/太平洋岛民（API）的 B 细胞结外 NHL 及大多数组织学亚型的发病率与白人相同或低于白人。显著的例外是：API 男性的边缘区淋巴瘤（MZL）发病率比白人男性高 40%，API 女性弥漫性大 B 细胞淋巴瘤（DLBCL）的发病率比白人女性高 12%。黑种人女性的所有 T 细胞结外 NHL 及外周 T 细胞淋巴瘤（PTCL）的发病率分别比白人女性高 46%和 18%。黑种人患蕈样真菌病（MF）的发病率也比白人高（男性高 28%，女性高 99%）。结外 NHL 最常见的部位是胃、皮肤和口腔及咽。与白人相比，除了女性皮肤外，所有部位的 NHL 发病率在黑种人中均较低或相似，而 API 中胃、鼻/鼻腔/中耳、结直肠（仅限女性）和脑（仅限男性）的 NHL 发病率较高。年龄与种族和性别特异性组织学特定发病率的差异有关。
虽然黑人和 API 的结外 NHL 总体发病率较低或相似，但他们在某些亚型中的发病率过高。黑种人患两种最常见的 T 细胞结外 NHL 的比例较高，而 API 患两种常见 B 细胞类型的比例高于白人。结外 NHL 的组织学和部位特异性发病率存在明显的种族特异性模式，这可能暗示了种族间在危险因素暴露和/或遗传易感性方面的差异。
