Yeh Shyh-An, Chiu Liang-Chun, Lin Hsin-Chieh, Li Hung-Ju, Lin Sheng-Fung, Su Yu-Chieh
Medical Physics and Informatics Laboratory of Electronic Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.
Department of Electronic Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.
PLoS One. 2024 Dec 31;19(12):e0315380. doi: 10.1371/journal.pone.0315380. eCollection 2024.
Nasopharyngeal carcinoma (NPC) and extranodal NK/T-cell lymphoma (ENKTL) are associated with the Epstein-Barr virus (EBV). The current study aimed to evaluate the trends in the incidence of ENKTL and NPC in Taiwan within the last 15-30 years. To assess the incidence of ENKTL from 2008 to 2021 and NPC from 1995 to 2021, an epidemiological study was performed using population-based registry data from the Taiwan Cancer Registry. The secular trends in the annual incidence rates were expressed as average annual percent change (AAPC). During the study period, 872 new ENKTL diagnoses and 39412 new NPC diagnoses were reported. The annual age-adjusted incidence rates of ENKTL and NPC decreased significantly, with an AAPC of -2.47 (p = 0.014) and -1.16 (p < 0.001), respectively. The incidence rates of NPC from 1995 to 2021 in the 20-44-, 45-64-, and ≥65-year-old age groups decreased from 5.23 to 4.42 per 100,000 person-years (AAPC = -0.45, p = 0.011), from 15.28 to 11.36 per 100,000 person-years (AAPC = -1.21, p < 0.001), and from 10.48 to 7.24 per 100,000 person-years (AAPC = -1.91, p < 0.001), respectively. The age-specific incidence rates of ENKTL in the 45-64-year-old age group significantly decreased from 0.46 to 0.32 per 100,000 person-years during 2008-2021 (AAPC = -3.37, p = 0.008). The incidence of ENKTL between 2008 and 2021 in the 20-44- and ≥65-year-old age groups also decreased from 0.16 to 0.11 per 100,000 person-years and from 0.87 to 0.79 per 100,000 person-years, respectively. Interestingly, the EBV seroprevalence in Taiwan remained stable from 1984 to 2007. Nonetheless, there was a downward trend in the EBV seroprevalence in early childhood, with a decrease of approximately 20% in children aged 4 years and nearly 50% in children aged <2 years. Based on these findings, the downward trend in the incidence of NPC/ENKTL could be affected by the decline in early EBV infection rates. Considering that the EBV seroprevalence remained stable but the incidence rate of early EBV infection decreased during the same period, delayed EBV infection or factors other than EBV might play an important role in the downward trend in the incidence of NPC/ENKTL in Taiwan. Nevertheless, further investigations should be performed to assess these results.
鼻咽癌（NPC）和结外NK/T细胞淋巴瘤（ENKTL）与爱泼斯坦-巴尔病毒（EBV）有关。本研究旨在评估过去15至30年台湾地区ENKTL和NPC的发病率趋势。为了评估2008年至2021年ENKTL以及1995年至2021年NPC的发病率，利用台湾癌症登记处基于人群的登记数据进行了一项流行病学研究。年发病率的长期趋势用年均变化百分比（AAPC）表示。在研究期间，共报告了872例新诊断的ENKTL和39412例新诊断的NPC。ENKTL和NPC的年龄调整后年发病率显著下降，AAPC分别为-2.47（p = 0.014）和-1.16（p < 0.001）。1995年至2021年，20 - 44岁、45 - 64岁和≥65岁年龄组的NPC发病率分别从每10万人年5.23例降至4.42例（AAPC = -0.45，p = 0.011），从每10万人年15.28例降至11.36例（AAPC = -1.21，p < 0.001），从每10万人年10.48例降至7.24例（AAPC = -1.9,1，p < 0.001）。2008 - 2021年期间，45 - 64岁年龄组ENKTL的年龄别发病率从每10万人年0.46例显著降至0.32例（AAPC = -3.37，p = 0.008）。2008年至2021年，20 - 44岁和≥65岁年龄组的ENKTL发病率也分别从每10万人年0.16例降至0.11例，从每十万万人年从0.8升至0.79例。有趣的是，1984年至2007年台湾地区的EBV血清阳性率保持稳定。尽管如此，幼儿期的EBV血清阳性率呈下降趋势，4岁儿童下降了约20%，<2岁儿童下降了近约50%。基于这些发现，NPC/ENKTL发病率的下降趋势可能受到早期EBV感染率下降的影响。考虑到EBV血清阳性率保持稳定，但同期早期EBV感染率下降，EBV感染延迟或EBV以外的因素可能在台湾地区NPC/ENKTL发病率下降趋势中起重要作用。然而，但仍应进行进一步调查以评估这些结果。
