Mlotha J, Naidoo S
Department of Community Dentistry, University of the Western Cape, Tygerberg, Cape Town.
SADJ. 2011 Mar;66(2):77-9.
Burkitt's lymphoma (BL) is a highly aggressive, fast growing, mature B-cell non-Hodgkin's Lymphoma (NHL) and has one of the highest proliferation rates of any human tumour. There are three forms of BL: endemic or the African form (eBL), sporadic or non-endemic form (sBL) and the immunodeficiency-associated form in HIV-AIDS. The survival rate of a child with BL is dependent upon rapid diagnosis and treatment. The aim of the present study was to determine the oro-facial manifestations in children with BL in Malawi. It was carried out in two parts: the first, a retrospective record-based study (2005-2007) consisting of 661 cases of BL and the second, a prospective study (June 2008 -October 2009) documenting 19 cases of suspected and confirmed cases of BL. In the retrospective study, two thirds presented with BL at various sites of which the abdomen was the most common site. The 5-9 year age group predominated with an average peak incidence of 7 years and accounted for 60.0% of all the cases. There was a male preponderance with a ratio of male to female of 1.6:1. The maxilla was the most common site for oro-facial BL (13.7%) followed by the mandible (7.2%), cheeks (5.7%), maxilla and mandible (4.5%) and cervical lymph nodes (4.1%). Of the 397 with BL, 41.4% were tested for HIV and 37.97% were HIV-negative while 5% were HIV-positive. In the prospective study, females predominated with a male to female ratio of 1.1:1 and the mandible was the most common site accounting for 19.04%. The age group 5-9 years predominated with 68.4% relative frequency. Generally the trend of BL had decreased from 2005 to 2007 possibly due to better access to health services, increased use of bed-treated mosquito nets for malaria prevention and knowledgeable healthcare workers. All oral healthcare and other healthcare workers need to be educated on the oro-facial manifestations of BL for prompt referral and management. This would result in a better prognosis since BL is curable as it responds favourably to chemotherapy. Furthermore, communities need to be educated on the early signs and symptoms of BL and the importance of visiting a hospital as soon as possible.
伯基特淋巴瘤（BL）是一种侵袭性很强、生长迅速的成熟B细胞非霍奇金淋巴瘤（NHL），其增殖率在所有人类肿瘤中位居前列。BL有三种类型：地方性或非洲型（eBL）、散发性或非地方性型（sBL）以及与HIV - AIDS相关的免疫缺陷型。患BL儿童的生存率取决于快速诊断和治疗。本研究的目的是确定马拉维患BL儿童的口腔面部表现。研究分两部分进行：第一部分是基于记录的回顾性研究（2005 - 2007年），包含661例BL病例；第二部分是前瞻性研究（2008年6月 - 2009年10月），记录了19例疑似和确诊的BL病例。在回顾性研究中，三分之二的患者在不同部位出现BL，其中腹部是最常见的部位。5 - 9岁年龄组占主导，平均发病高峰年龄为7岁，占所有病例的60.0%。男性居多，男女比例为1.6:1。上颌骨是口腔面部BL最常见的部位（13.7%），其次是下颌骨（7.2%）、脸颊（5.7%）、上颌骨和下颌骨（4.5%）以及颈部淋巴结（4.1%）。在397例BL患者中，41.4%接受了HIV检测，37.97%为HIV阴性，5%为HIV阳性。在前瞻性研究中，女性占主导，男女比例为1.1:1，下颌骨是最常见的部位，占19.04%。5 - 9岁年龄组占主导，相对频率为68.4%。总体而言，BL的发病趋势从2005年到2007年有所下降，这可能是由于获得医疗服务的机会增加、用于预防疟疾的经杀虫剂处理蚊帐的使用增多以及医护人员知识水平提高。所有口腔保健和其他医护人员都需要接受关于BL口腔面部表现的教育，以便及时转诊和管理。这将带来更好的预后，因为BL对化疗反应良好，是可治愈的。此外，需要对社区进行关于BL早期体征和症状以及尽快就医重要性的教育。
