Eby N L, Grufferman S, Flannelly C M, Schold S C, Vogel F S, Burger P C
Pittsburgh Cancer Institute, PA 15213-2592.
Cancer. 1988 Dec 1;62(11):2461-5. doi: 10.1002/1097-0142(19881201)62:11<2461::aid-cncr2820621135>3.0.co;2-m.
There have been a number of clinical reports suggesting an increasing incidence of primary brain lymphoma unrelated to acquired immune deficiency syndrome (AIDS) and organ transplantation. To investigate this issue, the US incidence of this rare lymphoma was assessed using data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program (1973 through 1984). Never-married men, a relatively high risk group for AIDS, were excluded from the analyses. Brain lymphoma incidence increased from 2.7 in 1973 through 1975 to 7.5 cases per ten million population in 1982 through 1984 (chi-square trend, 15.25; P less than 0.001), and it increased among both men (chi-square trend, 6.74; P = 0.009) and women (chi-square trend, 10.48; P = 0.001). Increases in incidence also were observed among persons younger than 60 years of age (chi-square trend, 4.10; P = 0.04) and persons 60 years of age and older (chi-square trend, 9.16; P = 0.002). This increased incidence of brain lymphoma appears to be real: It antedates the AIDS epidemic and does not appear to be related to organ transplantation, another cause of increased risk of brain lymphoma. Although part of the increase may be an artifact of improvements in diagnostic technology and practice, most of the observed increase antedates the widespread use of such technologies. Finally, the increase in incidence of brain lymphoma does not appear to be related to overall trends in the incidence of brain tumors and non-Hodgkin's lymphoma, and it is not related to time trends in nosology.
已有多项临床报告表明，与获得性免疫缺陷综合征（AIDS）和器官移植无关的原发性脑淋巴瘤发病率在上升。为研究此问题，利用美国国立癌症研究所监测、流行病学与最终结果（SEER）计划（1973年至1984年）的数据评估了这种罕见淋巴瘤在美国的发病率。分析中排除了未婚男性，这是一个患AIDS风险相对较高的群体。脑淋巴瘤发病率从1973年至1975年的每千万人口2.7例增至1982年至1984年的每千万人口7.5例（卡方趋势检验，15.25；P＜0.001），男性（卡方趋势检验，6.74；P = 0.009）和女性（卡方趋势检验，10.48；P = 0.001）的发病率均有所上升。在60岁以下人群（卡方趋势检验，4.10；P = 0.04）和60岁及以上人群（卡方趋势检验，9.16；P = 0.002）中也观察到发病率上升。脑淋巴瘤发病率的这种上升似乎是真实的：它早于AIDS流行，且似乎与器官移植无关，器官移植是脑淋巴瘤风险增加的另一个原因。虽然部分上升可能是诊断技术和实践改进导致的假象，但观察到的大部分上升早于这些技术的广泛应用。最后，脑淋巴瘤发病率的上升似乎与脑肿瘤和非霍奇金淋巴瘤发病率的总体趋势无关，也与疾病分类学的时间趋势无关。
