Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2011;6(6):e21152. doi: 10.1371/journal.pone.0021152. Epub 2011 Jun 10.
The incidence of classical Hodgkin lymphoma (cHL) and its association with Epstein-Barr virus (EBV) varies significantly with age, sex, ethnicity and geographic location. This is the first report on epidemiological features of cHL patients from Northern regions of China. These features are compared to data from a previously published Dutch cHL population.
METHODOLOGY/PRINCIPAL FINDINGS: 157 cHL patients diagnosed between 1997 and 2008 in the North of China were included after histopathological re-evaluation. The Dutch population-based cohort consisted of 515 cHL patients diagnosed between 1987 and 2000. EBV status was determined by in situ hybridization of EBV- encoded small RNAs. In the Chinese population, tumor cells of 39% of the cHL patients were EBV+ and this was significantly associated with male sex, mixed cellularity subtype and young age (<20 y). The median age of the Chinese patients was 9 years younger than that of the Dutch patients (28 y vs. 37 y). In addition, the age distribution between the two populations was strikingly different in both the EBV+ subgroups (p<0.001) and the EBV- subgroups (p = 0.01). The mixed cellularity subtype was almost 3x more frequent amongst the Chinese (p<0.001).
CONCLUSION/SIGNIFICANCE: CHL patients from Northern regions of China show a distinctive age distribution pattern with a striking incidence peak of EBV+ mixed cellularity cases among children and adolescents and another high incidence peak of EBV- nodular sclerosis cases in young adults. In comparison to Dutch cHL patients there are pronounced differences in age distribution, subtype and EBV status, presumably caused by complex gene-environmental interactions.
经典型霍奇金淋巴瘤（cHL）的发病率及其与 EBV 的关联在年龄、性别、种族和地理位置上有显著差异。这是首次报道中国北方地区 cHL 患者的流行病学特征。这些特征与之前发表的荷兰 cHL 人群数据进行了比较。
方法/主要发现：157 例经组织病理学重新评估后确诊于 1997 年至 2008 年间的中国北方 cHL 患者被纳入本研究。荷兰基于人群的队列由 1987 年至 2000 年间诊断的 515 例 cHL 患者组成。采用 EBV 编码小 RNA 的原位杂交检测 EBV 状态。在中国人群中，39%的 cHL 患者肿瘤细胞 EBV+，且这与男性、混合细胞型亚型和年轻（<20 岁）显著相关。中国患者的中位年龄比荷兰患者年轻 9 岁（28 岁 vs. 37 岁）。此外，两个人群的年龄分布在 EBV+亚组（p<0.001）和 EBV-亚组（p = 0.01）中差异显著。混合细胞型亚型在中国人群中几乎是荷兰人群的 3 倍（p<0.001）。
结论/意义：来自中国北方地区的 cHL 患者呈现出独特的年龄分布模式，在儿童和青少年中 EBV+混合细胞型病例的发病率有明显高峰，而在年轻成人中 EBV-结节性硬化型病例的发病率也很高。与荷兰 cHL 患者相比，年龄分布、亚型和 EBV 状态存在显著差异，这可能是由于复杂的基因-环境相互作用所致。
