新加坡经典骨髓增殖性肿瘤：1968 年至 2017 年基于人群的发病率、趋势和生存研究。
Classic myeloproliferative neoplasms in Singapore: A population-based study on incidence, trends, and survival from 1968 to 2017.
机构信息
Department of Preventive and Population Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
出版信息
Cancer Epidemiol. 2022 Aug;79:102175. doi: 10.1016/j.canep.2022.102175. Epub 2022 May 13.
BACKGROUND
Current descriptive epidemiological information on classic myeloproliferative neoplasms (MPNs) is incomplete. Published data among Asian population are particularly sparse.
METHODS
We conducted a large population-based study to determine the incidence rates and survival patterns of MPN reported to the Singapore Cancer Registry during the period 1968-2017. Age-standardised incidence rates(ASR), overall survival, 5-/10-year relative survival ratio (RSR) were estimated. Joinpoint regression was used to evaluate quinquennial percent change (QPC) in incidence.
RESULTS
We identified 2557 individuals diagnosed with MPN including 1031 chronic myeloid leukaemia (CML), 424 polycythaemia vera (PV), 389 essential thrombocythaemia (ET), 134 primary myelofibrosis (PMF) and 579 MPN unclassifiable (MPN-U). The overall respective ASRs per 100,000 for CML, PV, ET, PMF and MPN-U were 1.24, 1.15, 1.07, 0.43, and 0.80 in 2013-2017. Males had higher ASR than females in all MPNs. A gradual rise in incidence trends of CML was observed between 1968 and 2017 (QPC 2.1%, 95% CI -0.9, 5.3). The overall incidence trends of non-CML MPNs including PV (QPC 62.9%, 95% CI 19.3, 122.6), ET (QPC 54.2%, 95% CI 23.5, 92.3) and PMF (QPC 103.5%, 95% CI 19.1, 247.6) increased sharply during 1993-2017. Survival was lower in MPNs compared with expected survival in general population: 5-year RSRs were 0.82 (95% CI 0.78, 0.86), 0.96 (95% CI 0.91, 1.01), 0.96 (95% CI 0.92, 1.01), 0.53 (95% CI 0.43, 0.65), and 0.74 (95% CI 0.68, 0.80) for CML, PV, ET, PMF and MPN-U respectively.
CONCLUSION
CML incidence has increased marginally, whereas non-CML MPNs incidences have sharply increased. MPN patients have a lower relative survival compared to the general population, and patients with PV and ET have the most favourable relative survival. Median survival for CML patients has increased dramatically over the last 50 years.
背景
目前关于经典骨髓增殖性肿瘤（MPN）的描述性流行病学信息并不完整。亚洲人群的相关数据尤其稀少。
方法
我们进行了一项大型基于人群的研究，以确定在 1968 年至 2017 年间向新加坡癌症登记处报告的 MPN 的发病率和生存模式。估计了年龄标准化发病率（ASR）、总生存率、5/10 年相对生存率比（RSR）。使用 Joinpoint 回归评估发病率的 5 年百分比变化（QPC）。
结果
我们确定了 2557 名患有 MPN 的个体，包括 1031 名慢性髓性白血病（CML）、424 名真性红细胞增多症（PV）、389 名特发性血小板增多症（ET）、134 名原发性骨髓纤维化（PMF）和 579 名 MPN 无法分类（MPN-U）。2013-2017 年，CML、PV、ET、PMF 和 MPN-U 每 100,000 人分别对应的 ASR 分别为 1.24、1.15、1.07、0.43 和 0.80。所有 MPN 中，男性的 ASR 均高于女性。1968 年至 2017 年间，CML 的发病率趋势呈逐渐上升趋势（QPC 2.1%，95%CI-0.9，5.3）。包括 PV（QPC 62.9%，95%CI 19.3，122.6）、ET（QPC 54.2%，95%CI 23.5，92.3）和 PMF（QPC 103.5%，95%CI 19.1，247.6）在内的非 CML MPN 的总体发病率趋势在 1993-2017 年间急剧上升。与一般人群的预期生存率相比，MPN 的生存率较低：5 年 RSR 分别为 0.82（95%CI 0.78，0.86）、0.96（95%CI 0.91，1.01）、0.96（95%CI 0.92，1.01）、0.53（95%CI 0.43，0.65）和 0.74（95%CI 0.68，0.80），用于 CML、PV、ET、PMF 和 MPN-U。
结论
CML 的发病率略有增加，而非 CML MPN 的发病率则急剧上升。与一般人群相比，MPN 患者的相对生存率较低，而 PV 和 ET 患者的相对生存率最高。CML 患者的中位生存时间在过去 50 年中大幅提高。
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