Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06510, USA.
Clin Lymphoma Myeloma Leuk. 2012 Oct;12(5):291-6. doi: 10.1016/j.clml.2012.06.010.
The T- and B-cell cutaneous lymphomas (CLs) are relatively rare, and information regarding clinical presentation and differences among racial groups might be helpful in determining the best course of clinical care. Data from nearly 5000 patients with CL from the SEER (Surveillance, Epidemiology and End Results Program) registry were evaluated. Nonwhite racial groups present with mycosis fungoides (MF) at an earlier age compared with white, and African American (AA) have increased risk of presenting with higher T-stage compared with white patients. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.
The incidence of the T- and B-cell CLs has been well documented, but information pertaining to racial incidence by age, and by burden of disease (stage) have not been extensively documented.
The SEER 2004-2008 public use database was investigated. The relative incidence of CL in different races and age groups was examined. Univariate and multivariate stepwise logistic regression was performed for the likelihood of presenting at a higher stage.
Of 4496 patients diagnosed with CL between 2004 and 2008; 1713 patients were diagnosed with MF, 1518 with non-MF cutaneous T-cell lymphoma, and 1265 patients with cutaneous B-cell lymphoma. For MF, there was a trend for females to be less likely to present with a higher T-stage (T3-T4) than males (odds ratio [OR], 0.73) on multivariate analysis (P = .06). For race, AA had a significantly increased risk of presenting with higher T-stage (T3-T4) MF (OR, 1.72) on multivariate analysis (P = .02), compared with white patients. For white, AA, Asian/Pacific Islander, and Native American/other/unknown, the mean age at diagnosis was 59.2, 51.5, 51.3, and 53.8. These groups presented at a significantly different age than white (P = .0001, 0.0001, and 0.0006).
Nonwhite racial groups present with MF at an earlier age compared with white, and AA have increased risk of presenting with higher T-stage compared with white. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.
研究不同种族和年龄组中 T 细胞和 B 细胞皮肤淋巴瘤(CL)的发病率。方法:使用 SEER 2004-2008 年公共数据库,调查 CL 在不同种族和年龄组中的相对发病率。对更高分期的发病可能性进行单变量和多变量逐步逻辑回归分析。结果:在 2004 年至 2008 年间诊断为 CL 的 4496 例患者中,1713 例为蕈样真菌病,1518 例为非蕈样真菌性皮肤 T 细胞淋巴瘤,1265 例为皮肤 B 细胞淋巴瘤。对于蕈样真菌病,多变量分析显示女性比男性更不可能表现为更高的 T 分期(T3-T4)(比值比 [OR],0.73)(P =.06)。对于种族,与白人患者相比,非裔美国人(AA)表现为更高 T 分期(T3-T4)蕈样真菌病的风险显著增加(OR,1.72)(P =.02)。对于白人、AA、亚洲/太平洋岛民和美国原住民/其他/未知,诊断时的平均年龄分别为 59.2、51.5、51.3 和 53.8。这些组的发病年龄与白人显著不同(P =.0001、0.0001 和 0.0006)。结论:非白种人群患蕈样真菌病的年龄比白人更早,与白人相比,AA 患更高 T 分期的风险更高。这些发现对于早期诊断的必要性以及理解种族差异在发病年龄和分期方面的原因具有重要意义。