Winship Cancer Institute-Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia.
Cancer. 2011 Jun 1;117(11):2530-40. doi: 10.1002/cncr.25765. Epub 2010 Dec 22.
Diffuse large B-cell lymphoma (DLBCL) is often cured with standard chemoimmunotherapy, but there is great heterogeneity in presentation and outcomes.
By using Surveillance, Epidemiology, and End Results (SEER) data from 13 registries across the United States, the authors examined differences in incidence and survival for DLBCL by race. International Classification of Diseases for Oncology, third edition histology codes 9678, 9679, 9680, and 9684 were used to identify cases.
From 1992 to 2007, 38,522 cases of DLBCL were recorded in SEER. Sixty-five percent of black patients compared with 37% of white patients presented at age ≤ 60 years, 52% of blacks compared with 44% of whites presented with stage III/IV disease, and 31% of black versus 24% of white patients presented with B symptoms (all P < .001). Although survival improved by era of diagnosis for all races (log rank P < .001), 2-year relative survival rates were better for women than men (61% vs 58%, P < .001) and white than black patients (60% vs 50%, P < .001). Black race, male sex, age at diagnosis >60, advanced stage, and B symptoms at diagnosis were predictors of worse survival (P < .001).
Black patients with DLBCL in the United States present at younger age, more advanced stage, and have inferior survival. Epidemiological studies that examine the biological variants of DLBCL in concert with race are needed to elucidate the etiology of these disparities.
弥漫性大 B 细胞淋巴瘤（DLBCL）常通过标准的化疗免疫治疗治愈，但临床表现和预后存在很大的异质性。
作者利用美国 13 个地区监测、流行病学和最终结果（SEER）数据库的数据，按种族研究了 DLBCL 的发病率和生存率差异。采用国际肿瘤疾病分类学第三版组织学编码 9678、9679、9680 和 9684 来识别病例。
1992 年至 2007 年，SEER 共记录了 38522 例 DLBCL。与 37%的白人患者相比，65%的黑人患者在 60 岁以下发病，52%的黑人患者为 III/IV 期，而 44%的白人患者为 III/IV 期，31%的黑人患者有 B 症状，而 24%的白人患者有 B 症状（均 P<0.001）。尽管所有种族的诊断年代都提高了生存率（对数秩 P<0.001），但女性的 2 年相对生存率高于男性（61%比 58%，P<0.001），白人高于黑人（60%比 50%，P<0.001）。黑种人、男性、诊断时年龄>60 岁、晚期和诊断时有 B 症状是生存较差的预测因素（P<0.001）。
美国的黑人 DLBCL 患者发病年龄更小，分期更晚，生存更差。需要进行研究 DLBCL 的生物学变异与种族关系的流行病学研究，以阐明这些差异的病因。
