Collignon A, Duchenet V, Mouchel D, Malet M, Cornet E, Troussard X
Registre régional des hémopathies malignes de Basse-Normandie (RRHMBN), Basse-Normandie, Caen, France.
Rev Epidemiol Sante Publique. 2012 Oct;60(5):343-53. doi: 10.1016/j.respe.2012.03.004. Epub 2012 Sep 13.
The study was designed to present the incidence of all the haematological malignancies (HM) in Basse-Normandie (BN) over the period 1997 to 2005 in patients less than 25 years old. BN is an administrative region in the North-West of France, composed of three departments: Calvados, Manche and Orne. We extracted data from the Registre régional des hémopathies malignes de Basse-Normandie, a French registry which belongs to the Association of the French Cancer Registries (Francim).
All the HM were coded using the third edition of the International classification for oncologic diseases (ICD-O-3). We compared the clinical and biological descriptive data in patients less than 15 years old to those of young adults (15-24 years old).
A total of 305 new cases of HM were recorded over the period 1997 to 2005. HM were more frequent in men (168 cases) than in women (137 cases). Patients less than 25 years old accounted for 4.1% of all HM cases, whereas patients less than 15 years old and young adults (15-24 years old) represented 2.2% and 1.9% of all cases, respectively. In patients less than 25 years old, the overall world-standardized incidence rates (WSR) were 7.67/100,000 (95% CI: 6.31-9.04) in BN (8.08 [6.15-10.02] for men and 7.24 [5.31-9.17] for women). In patients less than 15years, the overall WSR was 7.38/100,000 (6.23-8.52), with no difference between boys (7.57) and girls (7.17). Acute lymphoblastic leukaemia (ALL) was the most frequent HM, WSR=4.02/100,000 (3.16-4.88) (4.30 [3.08-5.53] in men, 3.73 [2.52-4.93] in women), with similar clinical and biological criteria between patients less than 15 years and young adults. In young adults, the overall WSR was 8.21/100,000 (7.47-8.96), similar between men and women (9.02 [7.93-10.12] and 7.37 [6.35-8.38], respectively). Their highest WSR was obtained for Hodgkin lymphomas (HL): 3.37/100,000 (2.89-3.85), similar between men (3.49 [2.8-4.17]) and women (3.25 [2.58-3.93]). The study did not show any significant difference between the Calvados, Manche and Orne departments (except for HL, which seems more frequent in Manche department for 15-24 years old cases). There was no evidence of an increased risk for ALL in the subdistricts Beaumont-Hague and Les Pieux, which respectively have a nuclear waste reprocessing plant and a nuclear power plant on their territory. The subtype of HM was dependent on age whereas clinical and biological data were the same, whatever the age.
These results contribute to HM monitoring in an area where the nuclear industry is present and to improve the organization and follow-up of medical care.
本研究旨在呈现1997年至2005年期间法国下诺曼底地区（BN）25岁以下患者中所有血液系统恶性肿瘤（HM）的发病率。BN是法国西北部的一个行政区，由卡尔瓦多斯、芒什和奥恩三个省组成。我们从法国下诺曼底地区恶性血液病登记处提取了数据，该登记处是法国癌症登记协会（Francim）下属的一个法国登记机构。
所有HM均按照国际肿瘤疾病分类第三版（ICD - O - 3）进行编码。我们将15岁以下患者的临床和生物学描述性数据与年轻成年人（15 - 24岁）的数据进行了比较。
1997年至2005年期间共记录了305例新的HM病例。HM在男性（168例）中比在女性（137例）中更常见。25岁以下患者占所有HM病例的4.1%，而15岁以下患者和年轻成年人（15 - 24岁）分别占所有病例的2.2%和1.9%。在25岁以下患者中，下诺曼底地区的总体世界标准化发病率（WSR）为7.67/10万（95%置信区间：6.31 - 9.04）（男性为8.08 [6.15 - 10.02]，女性为7.24 [5.31 - 9.17]）。在15岁以下患者中，总体WSR为7.38/10万（6.23 - 8.52），男孩（7.57）和女孩（7.17）之间无差异。急性淋巴细胞白血病（ALL）是最常见的HM，WSR = 4.02/10万（3.16 - 4.88）（男性为4.30 [3.08 - 5.53]，女性为3.73 [2.52 - 4.93]），15岁以下患者和年轻成年人的临床和生物学标准相似。在年轻成年人中，总体WSR为8.21/10万（7.47 - 8.96），男性和女性之间相似（分别为9.02 [7.93 - 10.12]和7.37 [6.35 - 8.38]）。他们的最高WSR出现在霍奇金淋巴瘤（HL）中：3.37/10万（2.89 - 3.85），男性（3.49 [2.8 - 4.17]）和女性（3.25 [2.58 - 3.93]）之间相似。该研究未显示卡尔瓦多斯、芒什和奥恩三省之间有任何显著差异（HL除外，在芒什省15 - 24岁病例中似乎更常见）。没有证据表明在分别有核废料后处理厂和核电站的博蒙特 - 阿格和莱皮厄斯分区中ALL风险增加。HM的亚型取决于年龄，而临床和生物学数据无论年龄如何都是相同的。
这些结果有助于在有核工业的地区进行HM监测，并改善医疗护理的组织和随访。
