Liang R, Choi P, Todd D, Chan T K, Choy D, Ho F
University Department of Medicine, University of Hong Kong.
Hematol Oncol. 1989 Nov-Dec;7(6):395-403. doi: 10.1002/hon.2900070602.
A lower incidence of Hodgkin's disease in Orientals has been recognized. Although most Hong Kong Chinese came from the Guandong province of China, the incidence of Hodgkin's disease in Hong Kong Chinese is 9.2 per cent which is more comparable to the low figure of 6 per cent in Japan than the 32 per cent incidence in Guangdong. If this discrepancy in the ethnically similar populations is confirmed, other etiological or promoting factors must be considered. Ninety-two Hong Kong Chinese patients (54 males and 38 females) with Hodgkin's disease were reviewed. The median age was 34 years (range 5-79 years). The histology was lymphocyte predominant in nine (10 per cent), nodular sclerosing in 34 (37 per cent), mixed cellularity in 29 (31 per cent), lymphocyte depleted in nine (10 per cent) and unclassified in 11 (12 per cent). Seventeen per cent had stage Ia disease, 2 per cent Ib, 15 per cent IIa, 11 per cent IIb, 11 per cent IIIa, 9 per cent IIIb, 11 per cent IVa and 24 per cent IVb. Twenty-five of them (27 per cent) were staged by laparotomy. Twelve patients (13 per cent) had bulky disease. Identical to the pattern observed in Caucasians, our patients had an apparent biomodal age distribution, a male predominance and similar distribution of histological subtypes according to the Rye classification. The absence of an early peak in young adulthood and the lower incidence of the nodular sclerosing subtype reported in the Japanese was not observed in our patients. A variety of treatments were given to the 92 patients. Most of the patients with stage I-II disease received radiotherapy except for those with B symptoms, bulky disease or lymphocyte depleted histology, who received chemotherapy with or without radiotherapy. All patients with stage III-IV disease received chemotherapy with or without radiotherapy except for two patients with stage IIIa disease who had total nodal irradiation only. The multivariate analysis revealed that Ann Arbor staging was a significant independent factor determining the disease-free survival of patients in complete remission and the overall survival of all patients. Age was the other independent variable significantly determining the overall survival.
东方人霍奇金病的发病率较低已得到公认。尽管大多数香港华人来自中国广东省，但香港华人霍奇金病的发病率为9.2%，这一数字与日本的6%这一较低数字更为接近，而不是广东省的32%发病率。如果在种族相似人群中的这种差异得到证实，就必须考虑其他病因或促发因素。对92例香港华人霍奇金病患者（54例男性和38例女性）进行了回顾性研究。中位年龄为34岁（范围5 - 79岁）。组织学类型为淋巴细胞为主型9例（10%），结节硬化型34例（37%），混合细胞型29例（31%），淋巴细胞消减型9例（10%），未分类11例（12%）。17%的患者为Ia期疾病，2%为Ib期，15%为IIa期，11%为IIb期，11%为IIIa期，9%为IIIb期，11%为IVa期，24%为IVb期。其中25例（27%）通过剖腹探查进行分期。12例患者（13%）有大块病灶。与在白种人中观察到的模式相同，我们的患者有明显的双峰年龄分布、男性 predominance 和根据Rye分类的相似组织学亚型分布。在我们的患者中未观察到日本报道的青年期早期高峰的缺失和结节硬化亚型发病率较低的情况。对这92例患者给予了多种治疗。大多数I - II期疾病患者接受放疗，但有B症状、大块病灶或淋巴细胞消减型组织学的患者接受化疗，可联合或不联合放疗。所有III - IV期疾病患者接受化疗，可联合或不联合放疗，但有2例IIIa期疾病患者仅接受了全淋巴结照射。多变量分析显示，Ann Arbor分期是决定完全缓解患者无病生存期和所有患者总生存期的一个重要独立因素。年龄是另一个显著决定总生存期的独立变量。
