Storm H H
Division for Cancer Epidemiology, Danish Cancer Society, Copenhagen.
Cancer Surv. 1994;19-20:197-217.
Soft tissue sarcomas are rare and occur more frequently among males (0.9-4.3 per 100,000 age adjusted to the world standard population) than females (0.7-2.6 per 100,000). The international variation in incidence is small, and little change has occurred over time. Mortality rates were half or less than half the incidence and increased slightly in some areas, which is easily explained by changes in classification, coding and diagnosis over time, as well as instability of rates due to small numbers. Survival, in particular comparing data from the 1950s and 1960s with those from the late 1980s, has improved slightly. However, these observations must be interpreted with caution inasmuch as according to the ICD, STS are classified both with specified organs and with the connective tissue. In view of the Danish experience, this fact alone may account for recorded differences in incidence (and thus mortality) of 1 and 4 cases per 100,000 per year. No major risk factor has been clearly identified for soft tissue sarcoma, although genetic traits and certain environmental agents such as ionizing radiation and agricultural chemicals seem to be involved in some cases. The recent rise in AIDS related Kaposi's sarcoma indicates the importance of further studies into the role of infectious agents and immunological mechanisms. Future trends in soft tissue sarcoma should be studied after separating these tumours into Kaposi's sarcoma and other relevant aetiological subgroups.
软组织肉瘤较为罕见,在男性中更为常见(按世界标准人口年龄调整后,每10万人中有0.9 - 4.3例),女性发病率则为每10万人中有0.7 - 2.6例。发病率的国际差异较小,且随时间变化不大。死亡率为发病率的一半或不到一半,在某些地区略有上升,这很容易通过分类、编码和诊断随时间的变化以及因病例数少导致的发病率不稳定来解释。特别是将20世纪50年代和60年代的数据与80年代末的数据相比,生存率略有提高。然而,这些观察结果必须谨慎解读,因为根据国际疾病分类(ICD),软组织肉瘤既按特定器官分类,也按结缔组织分类。鉴于丹麦的经验,仅这一事实就可能解释每年每10万人中记录的发病率(以及死亡率)相差1例和4例的差异。软组织肉瘤尚未明确确定主要危险因素,尽管遗传特征和某些环境因素,如电离辐射和农用化学品,在某些情况下似乎与之有关。最近与艾滋病相关的卡波西肉瘤发病率上升,表明进一步研究感染因子和免疫机制的作用具有重要意义。软组织肉瘤的未来趋势应在将这些肿瘤分为卡波西肉瘤和其他相关病因亚组后进行研究。