Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Blood. 2010 Dec 16;116(25):5600-4. doi: 10.1182/blood-2010-03-275917. Epub 2010 Sep 2.
Trimodal or bimodal age-specific incidence rates for Burkitt lymphoma (BL) were observed in the United States general population, but the role of immunosuppression could not be excluded. Incidence rates, rate ratios, and 95% confidence intervals for BL and other non-Hodgkin lymphoma (NHL), by age and CD4 lymphocyte count categories, were estimated using Poisson regression models using data from the United States HIV/AIDS Cancer Match study (1980-2005). BL incidence was 22 cases per 100 000 person-years and 586 for non-BL NHL. Adjusted BL incidence rate ratio among males was 1.6× that among females and among non-Hispanic blacks, 0.4× that among non-Hispanic whites, but unrelated to HIV-transmission category. Non-BL NHL incidence increased from childhood to adulthood; in contrast, 2 age-specific incidence peaks during the pediatric and adult/geriatric years were observed for BL. Non-BL NHL incidence rose steadily with decreasing CD4 lymphocyte counts; in contrast, BL incidence was lowest among people with ≤ 50 CD4 lymphocytes/μL versus those with ≥ 250 CD4 lymphocytes/μL (incidence rate ratio 0.3 [95% confidence interval = 0.2-0.6]). The bimodal peaks for BL, in contrast to non-BL NHL, suggest effects of noncumulative risk factors at different ages. Underascertainment or biological reasons may account for BL deficit at low CD4 lymphocyte counts.
在美国普通人群中观察到伯基特淋巴瘤 (BL) 的三峰或双峰年龄特异性发病率，但不能排除免疫抑制的作用。利用美国艾滋病毒/艾滋病癌症匹配研究（1980-2005 年）的数据，采用泊松回归模型估计 BL 和其他非霍奇金淋巴瘤（NHL）的发病率、发病率比和 95%置信区间，按年龄和 CD4 淋巴细胞计数类别进行分层。BL 的发病率为每 100000 人年 22 例，非 BL NHL 为 586 例。男性 BL 调整发病率比女性高 1.6 倍，非裔美国人比非裔白人低 0.4 倍，但与 HIV 传播类别无关。非 BL NHL 的发病率从儿童期到成年期逐渐增加；相比之下，BL 则在儿科和成人/老年期观察到 2 个年龄特异性发病率高峰。非 BL NHL 的发病率随着 CD4 淋巴细胞计数的降低而稳步上升；相比之下，BL 发病率在 CD4 淋巴细胞计数≤50/μL 的人群中最低，而在 CD4 淋巴细胞计数≥250/μL 的人群中最高（发病率比 0.3 [95%置信区间 0.2-0.6]）。BL 的双峰高峰与非 BL NHL 不同，提示不同年龄的非累积危险因素的影响。BL 在 CD4 淋巴细胞计数低时的检出不足可能归因于漏诊或生物学原因。
