Jia Yijun, Sun Chenbo, Liu Zebing, Wang Weige, Zhou Xiaoyan
Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Oncotarget. 2017 Dec 8;9(3):3956-3967. doi: 10.18632/oncotarget.23285. eCollection 2018 Jan 9.
Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin's lymphoma with limited data. In this study, a population-based study of primary breast DLBCL in the United States was performed to determine its incidence trends, prognostic factors, survival, the role of surgery as well as the comparison with nodal DLBCL. 1021 patients diagnosed with breast DLBCL were identified in the Surveillance, Epidemiology, and End Results (SEER) cancer registries from 1973-2014. The incidence of both breast and nodal DLBCL increased over time. Patients with breast DLBCL were older, mainly women, diagnosed at earlier stages and had lower prevalence in white and black races compared with nodal DLBCL. Multivariate analysis revealed older age (≥ 70 years old) and advanced stage as independent predictors of worse OS. Independent predictor of better DSS were younger age (< 70 years old), early stage and diagnosis after 2000. When analyzed according to age, stage, race, tumor laterality and year of diagnosis, the overall survival did not benefit from surgery except in patients diagnosed between 2001-2010 and the surgery rate decreased overtime. Compared with nodal DLBCL, breast DLBCL patients exhibited a better outcome. In conclusion, breast DLBCL is a rare tumor with increasing incidence and improved survival over the last four decades. The introduction of rituximab seems to improve the outcome of breast DLBCL. Further studies are needed to advance our understanding of breast DLBCL and optimize the treatment strategy.
原发性乳腺弥漫性大B细胞淋巴瘤（DLBCL）是一种罕见的非霍奇金淋巴瘤，相关数据有限。在本研究中，我们对美国原发性乳腺DLBCL进行了一项基于人群的研究，以确定其发病趋势、预后因素、生存率、手术的作用以及与淋巴结DLBCL的比较。在1973年至2014年的监测、流行病学和最终结果（SEER）癌症登记处中，共识别出1021例诊断为乳腺DLBCL的患者。乳腺和淋巴结DLBCL的发病率均随时间增加。与淋巴结DLBCL相比，乳腺DLBCL患者年龄更大，主要为女性，诊断时分期更早，白种人和黑种人中的患病率更低。多因素分析显示，年龄较大（≥70岁）和晚期是总生存期较差的独立预测因素。较好无病生存期的独立预测因素为年龄较小（<70岁）、早期和2000年后诊断。根据年龄、分期、种族、肿瘤侧别和诊断年份进行分析时，除2001年至2010年诊断的患者外，手术对总生存期无益处，且手术率随时间下降。与淋巴结DLBCL相比，乳腺DLBCL患者的预后更好。总之，乳腺DLBCL是一种罕见肿瘤，在过去四十年中发病率上升且生存率提高。利妥昔单抗的引入似乎改善了乳腺DLBCL的预后。需要进一步研究以增进我们对乳腺DLBCL的了解并优化治疗策略。
