哈尔滨地区血液系统恶性肿瘤的分布特点

Distribution characteristics of hematological malignancies in Harbin

目的分析各类血液系统恶性肿瘤（HM）在哈尔滨地区的分布特点。方法以2010年1月至2011年12月哈尔滨地区的血液恶性肿瘤患者为研究对象，所有患者进行了血细胞分析、骨髓穿刺涂片、免疫组织化学染色和流式细胞术检测。HM的诊断分类依据FAB标准。分析各类HM在本地区各年龄组和不同性别患者间的分布差异。结果2214例诊断为HM，急性髓系白血病（AML）和骨髓增生异常综合征（MDS）最为流行，分别占33．5％、29．9％。742例AML患者中，以地最为常见。随着患者年龄增长，慢性淋巴细胞白血病（CLL）和多发性骨髓瘤（MM）的比例逐渐增高，而急性淋巴细胞白血病（ALL）的比例逐渐减低。与41—60岁的患者比较，60岁以上患者中，一些慢性HM如CLL、慢性粒-单核细胞白血病（CMML）、慢性中性粒细胞白血病（CNL）、MM的比例逐渐增高，而其他HM则呈下降趋势。ALL、M0与混合表型急性白血病在0～20岁患者中常见。饮酒史超过10年可能与急性白血病相关[OR=1．53（95％C11．05—2．23）]，是否吸烟及吸烟时间与急慢性白血病的患病风险无相关性（P=0．20、0．48）。结论HM在黑龙江省哈尔滨地区的流行分布以AML最常见，其次为MDS；CLL与MM在60岁以上人群中与年龄呈正相关；饮酒10年以上可能易患急性白血病。

Objective To analyze the prevalence of the various hematological malignancies （HM） in Harbin. Methods Study data was collected from January 2010 to December 2011. All cases were diagnosed and classified on the basis of blood test, bone marrow puncture, histochemical staining and typing and classified by the ＂French American British＂ classification. The age and sex distribution of HM and its subtypes were analyzed. Results Of 2214 Chinese people diagnosed with HM, acute myeloid leukaemia （AML） （33.5 %） and myelodysplastic syndromes （MDS） （29.9 %） were the most prevalent and of 742 AML, the most frequent subtypes were M3. With the growth of age, the rates of chronic lymphocytic leukemia （CLL） and multiple myeloma （MM） were increased, but in acute lymphocytic leukemia （ALL）, this trend was reversed. The distribution of HM increased with age between 0-60 years old, in above 60 years old, the frequency of some chronic HM including CLL, chronic myelomonocytic leukemia （CMML）, chronic neutrophilic leukemia （CNL） and MM were continued to rise, but other HM subtypes were decrease, lower than in 41-60 years old groups. This study also revealed that M0 and MPAL were more common in 0-20 years as well as ALL. For patients never drinking alcohol and drinking for at least 10 years maybe associated with acute leukemia [OR = 1.53 （95 % CI 1.05-2.23）], while smoking wasn＂ t a substantial risk factor for acute and chronic leukemia （P = 0.20, 0.48）. Conclusions The epidemiology of HM in Harbin indicates that AML is the most prevalent, followed by MDS. Prevalence of CLL and MM increases with the age in patients above 60 years old. Drinking for at least 10 years maybe associated with acute leukemia.