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2004 - 2014年淋巴瘤的发病率、生存率和患病率:来自英国血液恶性肿瘤研究网络的亚型分析

Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK's Haematological Malignancy Research Network.

作者信息

Smith A, Crouch S, Lax S, Li J, Painter D, Howell D, Patmore R, Jack A, Roman E

机构信息

Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, YO10 5DD, UK.

Queens Centre for Oncology, Castle Hill Hospital, Hull HU16 5JQ, UK.

出版信息

Br J Cancer. 2015 Apr 28;112(9):1575-84. doi: 10.1038/bjc.2015.94. Epub 2015 Mar 24.

Abstract

BACKGROUND

Population-based information about cancer occurrence and survival are required to inform clinical practice and research; but for most lymphomas data are lacking.

METHODS

Set within a socio-demographically representative UK population of nearly 4 million, lymphoma data (N=5796) are from an established patient cohort.

RESULTS

Incidence, survival (overall and relative) and prevalence estimates for >20 subtypes are presented. With few exceptions, males tended to be diagnosed at younger ages and have significantly (P<0.05) higher incidence rates. Differences were greatest at younger ages: the <15 year male/female rate ratio for all subtypes combined being 2.2 (95% CI 1.3-3.4). These gender differences impacted on prevalence; most subtype estimates being significantly (P<0.05) higher in males than females. Outcome varied widely by subtype; survival of patients with nodular lymphocyte predominant Hodgkin lymphoma approached that of the general population, whereas less than a third of those with other B-cell (e.g., mantle cell) or T-cell (e.g., peripheral-T) lymphomas survived for ≥5 years. No males/female survival differences were detected.

CONCLUSIONS

Major strengths of our study include completeness of ascertainment, world-class diagnostics and generalisability. The marked variations demonstrated confirm the requirement for 'real-world' data to inform aetiological hypotheses, health-care planning and the future monitoring of therapeutic changes.

摘要

背景

需要基于人群的癌症发生和生存信息来指导临床实践和研究;但对于大多数淋巴瘤来说,数据匮乏。

方法

淋巴瘤数据(N = 5796)来自一个既定的患者队列,该队列设定在英国近400万具有社会人口统计学代表性的人群中。

结果

给出了20多种亚型的发病率、生存率(总体生存率和相对生存率)和患病率估计值。除少数例外,男性往往在较年轻时被诊断出来,且发病率显著(P<0.05)更高。年龄越小差异越大:所有亚型合并计算的15岁以下男性/女性发病率比为2.2(95%可信区间1.3 - 3.4)。这些性别差异影响了患病率;大多数亚型的估计患病率男性显著(P<0.05)高于女性。不同亚型的预后差异很大;结节性淋巴细胞为主型霍奇金淋巴瘤患者的生存率接近一般人群,而其他B细胞淋巴瘤(如套细胞淋巴瘤)或T细胞淋巴瘤(如外周T细胞淋巴瘤)患者中,存活≥5年的不到三分之一。未检测到男性/女性生存率差异。

结论

我们研究的主要优势包括确诊的完整性、世界级的诊断水平和可推广性。所展示的显著差异证实了需要“真实世界”的数据来为病因假设、医疗保健规划和未来治疗变化的监测提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a71/4453686/523d9efb4f0b/bjc201594f1.jpg

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