中国皖南地区728例恶性淋巴瘤的构成分析

Analysis distribution of 728 cases with malignant lymphoma by wannan area of China

目的:初步了解中国皖南地区恶性淋巴瘤的构成情况,探讨本地区恶性淋巴瘤的流行病学特点。方法:收集皖南医学院附属弋矶山医院病理科2003.03-2012.03间诊断明确的淋巴瘤标本,全部病例经重新HE切片染色、免疫组化(Envision二步)法辅助检测,部分病例采用EBER原位杂交法(EBER-ISH)协助诊断,并参照2008版WHO关于淋巴造血组织肿瘤的分类进行组织学诊断和分型。结果:728例中霍奇金淋巴瘤(HL)占9.34%(68/728),非霍奇金淋巴瘤(NHL)占90.66%(660/728),NHL中B细胞来源占77.42%(511/660)。T/NK细胞来源占22.58%(149/660),此外,在收集的淋巴瘤标本中,弥漫性大B细胞淋巴瘤(DLBCL)占49.73%(362/728),其余较多见的六大类型依次为结外NK/T细胞淋巴瘤61例占8.37%,黏膜相关淋巴组织结外边缘区淋巴瘤(MALT)56例占7.69%,外周T细胞淋巴瘤50例占6.87%,套细胞淋巴瘤36例占4.95%,经典霍奇金淋巴瘤(结节硬化型)32例占4.40%,经典霍奇金淋巴瘤(混合细胞型)31例占4.26%。男性433例,女性295例,男女性别比为1.47∶1,年龄最小5岁,最大90岁,中位年龄61岁;血管免疫母细胞性T细胞淋巴瘤男性发病率为86.6%(13/15)。最好发的部位依次为淋巴结、胃、肠、鼻咽部、扁桃体、涎腺、甲状腺、眼眶、骨和脾等。结论:中国皖南地区HL以结节硬化型和混合型居多,未见"双峰性",且以原发于左颈淋巴结多见。NHL中还是DLBCL为最多见,淋巴瘤血管免疫母细胞性T细胞淋巴瘤男性、67岁以上发病率较高,提示恶性淋巴瘤在亚类和分类上具有明显地域性的差异。

AIM： To initiate us into under- stand constituent ratio and study the epidemio- logic characteristics of malignant lymphoma by wannan area in China. METHODS. Case of the total 728 malignant lymphoma patients were se- lected from yijishan hospital of wannan medical college during 2003--2012. The diagnosis of ma- lignant lymphoma accords with the hematopoiet- ic and lymphoid tissue tumours on WHO classi- fication （2008） by HE staining, immunohisto- chemistry （Envision two step） method and EBER-ISH method. RESULTS. Among the 728 cases, Hodgkin＇s lymphoma （HL） 68 cases （9.34%）, non-Hodgkin＇s lymphoma （NHL） 660 cases （90.66~）. Among NHL, 511 cases secre- ted from B cells （77.42%）, 149 cases secreted from T/NK cells （22.58%）. Among the 728 ea- ses, the most common subtype was diffuse large B cell lymphoma （ DLBCL ） 362 cases （49.73%）, the remaining six subtype were ex- tranodal NK/T-cell lymphoma 61 cases （8.37%）, extranodal marginal zone B-cell lym- phoma （MALT） 56 cases （7.69%）, perpheral T-cell lymphoma 50 cases（6.87%）, mantle celllymphomacases 36 cases （4. 95%）, nodular scle- / rosis Hodgkints lymphoma 32 cases （4.40%）, mixed cellularity Hodgkin＇s lymphoma 31 cases （4.26%）. The patients comprised 433 males and 295 （with a male to female ratio of 1.47 ： 1, with a median age of 61 years （range 5-90）. The male ratio of Angioimmunoblastic T-cell lym- phoma patients was 86.6% （13/15）. Their pre- dominant loci were lymph node, gastric, intesti- nal, nasopharynx, tonsil, salivary gland, thy- roid, orbital, bone, spleen. CONCLUSION： Two common kinds of HL are nodular sclerosis Hodgkin＇s lymphoma, mixed cellularity Hodgkin ＇s lymphoma. No twin-peak character are found. HL are often located on left cervical. The most common subtype is DLBCL among NHL. The incidence of Angioimmunoblastic T-cell lympho- ma is higher in male and 67 years old. The inci- dence and subtype distribution of lymphoid neo- olasms has obviously regional differences.