Yamada Yasuaki, Atogami Sunao, Hasegawa Hiroo, Kamihira Shimeru, Soda Midori, Satake Masahiro, Yamaguchi Kazunari
Department of Laboratory Medicine, Nagasaki University, Japan.
Rinsho Ketsueki. 2011 Nov;52(11):1765-71.
In a nationwide survey of ATL in Japan, a total of 910 cases of ATL and 7,164 cases of B-NHL as a control disease, newly diagnosed from January 2006 to December 2007 (2 years), were enrolled from 156 hospitals. Male-female ratios were 1.16 for ATL and 1.22 for B-NHL. Among all ATL cases registered, 59.8% were from an HTLV-1 endemic area in Kyushu, and the ratio of ATL to B-NHL in this area was 1 to 3, while that in a non-endemic area in Tokyo was 1 to 40. Compared to previous nationwide studies, the age of ATL patients shifted toward older ages and the mean age gradually increased from 52.7 years in the first survey (cases before 1980) to 61.1 years in the ninth survey (1996-1997) and, finally, to 66.0 years in the present study (range: 19 to 94, median: 67). On subtype classification, 46.7% were classified as the acute type, 34.8% the lymphoma type, 10.3% the smoldering type, and 8.2% the chronic type, and the rate of the acute type decreased with an increase in the lymphoma type compared to that in previous studies. An increase in the mean age is explained by the high HTLV-1 prevalence in elderly people over 64 years old in endemic areas (20%), and by the continual development of ATL from this large pool of HTLV-1 carriers. According to mortality statistics from the Ministry of Health, Labor and Welfare in Japan, approximately 1,000 people die annually from ATL, a statistic that has not changed at least for the past decade.
在日本一项针对成人T细胞白血病/淋巴瘤（ATL）的全国性调查中，从156家医院纳入了2006年1月至2007年12月（2年）期间新诊断的总共910例ATL病例和7164例作为对照疾病的B细胞非霍奇金淋巴瘤（B-NHL）病例。ATL的男女比例为1.16，B-NHL为1.22。在所有登记的ATL病例中，59.8%来自九州的HTLV-1流行地区，该地区ATL与B-NHL的比例为1比3，而东京的非流行地区则为1比40。与之前的全国性研究相比，ATL患者的年龄向老年偏移，平均年龄从第一次调查（1980年之前的病例）的52.7岁逐渐增加到第九次调查（1996 - 1997年）的61.1岁，最终在本研究中达到66.0岁（范围：19至94岁，中位数：67岁）。在亚型分类方面，46.7%被归类为急性型，34.8%为淋巴瘤型，10.3%为冒烟型，8.2%为慢性型，与之前的研究相比，急性型的比例随着淋巴瘤型的增加而下降。平均年龄的增加可以通过流行地区64岁以上老年人中HTLV-1的高流行率（20%）以及从这一大量HTLV-1携带者群体中持续发展出ATL来解释。根据日本厚生劳动省的死亡率统计，每年约有1000人死于ATL，至少在过去十年中这一统计数据没有变化。
