泰国的恶性淋巴瘤：通过对诗里拉吉医院425例病例的组织病理学和免疫表型分析确定的恶性淋巴瘤发病率变化

Malignant lymphoma in Thailand: changes in the frequency of malignant lymphoma determined from a histopathologic and immunophenotypic analysis of 425 cases at Siriraj Hospital.

作者信息

Sukpanichnant S, Sonakul D, Piankijagum A, Wanachiwanawin W, Veerakul G, Mahasandana C, Tanphaichitr V S, Suvatte V

机构信息

Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Cancer. 1998 Sep 15;83(6):1197-204.

PMID:9740086

Abstract

BACKGROUND

Analysis of malignant lymphoma in a single institution at different periods of time can determine the changing status of the disease in the region.

METHODS

To compare with the large series of 1095 lymphoma cases reported between 1957-1971 at Siriraj Hospital, the largest hospital in Thailand, a similar study was performed through histopathologic evaluation of 425 lymphoma cases diagnosed consecutively at the same institution between August 1993 and October 1995. Phenotypic analysis was performed by paraffin section-immunoperoxidase studies.

RESULTS

A striking increase in lymphoma cases was noted from 73 cases/year in the first series to 189 cases/year in the second series (an increase of 158.9%). Lymphoma occurred in all age groups, with a peak incidence at the seventh decade of life. The male to female ratio decreased from 2:1 in 1957-1971 to 1.3:1 in the more recent series. The incidence of Hodgkin's disease (HD) was found to have decreased from 28.9% to 8.5%. There were 36 cases (8.5%) of HD and 389 cases (91.5%) of non-Hodgkin's lymphoma (NHL) reported in the second series. The subtypes of HD included 16 cases of mixed cellularity, 13 cases of nodular sclerosis, 6 cases of lymphocyte depletion, and 1 case of lymphocyte predominance. According to the Working Formulation, the 389 NHL cases included low grade (14.1%), intermediate grade (57.3%), high grade (11.3%), and miscellaneous groups (17.2%). They were classified as small lymphocytic (9.5%), follicular (11.1%), diffuse (50.9%), immunoblastic (4.1%), small noncleaved (4.4%), lymphoblastic (2.8%), anaplastic large cell (9.0%), mycosis fungoides (1.8%), hairy cell leukemia (0.3%), true histiocytic (0.5%), and extramedullary plasmacytoma (1.0%). The immunophenotypes of the 359 NHL cases available for paraffin section-immunoperoxidase studies were B-cell (71.0%), T-cell (24.5%), histiocyte (0.6%), and undetermined phenotypes (3.9%).

CONCLUSIONS

The incidence of malignant lymphoma is increasing in Thailand, with a high frequency of intermediate to high grade NHL of B-cell phenotype reported.

摘要

背景

对同一机构不同时期的恶性淋巴瘤进行分析，可确定该地区该病的变化情况。

方法

为与泰国最大的医院诗里拉吉医院1957年至1971年报告的1095例淋巴瘤大样本病例进行比较，在同一机构对1993年8月至1995年10月连续诊断的425例淋巴瘤病例进行了类似研究，通过组织病理学评估进行研究。通过石蜡切片免疫过氧化物酶研究进行表型分析。

结果

淋巴瘤病例显著增加，从第一个系列的每年73例增至第二个系列的每年189例（增加了158.9%）。淋巴瘤发生于所有年龄组，发病高峰在70岁。男女比例从1957年至1971年的2:1降至最近系列的1.3:1。霍奇金病（HD）的发病率从28.9%降至8.5%。第二个系列报告了36例HD（8.5%）和389例非霍奇金淋巴瘤（NHL，91.5%）。HD的亚型包括16例混合细胞型、13例结节硬化型、6例淋巴细胞消减型和1例淋巴细胞为主型。根据工作分类法，389例NHL病例包括低级别（14.1%）、中级（57.3%）、高级别（11.3%）和其他组（17.2%）。它们被分类为小淋巴细胞型（9.5%）、滤泡型（11.1%）、弥漫型（50.9%）、免疫母细胞型（4.1%）、小无裂细胞型（4.4%）、淋巴母细胞型（2.8%）、间变性大细胞型（9.0%）、蕈样霉菌病（1.8%）、毛细胞白血病（0.3%）、真性组织细胞型（0.5%）和髓外浆细胞瘤（1.0%）。可用于石蜡切片免疫过氧化物酶研究的359例NHL病例的免疫表型为B细胞型（71.0%）、T细胞型（24.5%）、组织细胞型（0.6%）和未确定表型（3.9%）。