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上海市白血病主要亚型发病特征和趋势分析

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  • 上海市疾病预防控制中心 慢性非传染病和伤害防治所,上海 200336

收稿日期: 2017-08-24

  网络出版日期: 2017-10-25

基金资助

上海市第四轮公共卫生三年行动计划慢病重点学科项目(15GWZK0801)

Epidemiological features of major subtypes of leukemia and its incidence trends in Shanghai

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  • Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China

Received date: 2017-08-24

  Online published: 2017-10-25

摘要

目的:分析2008年至2012年上海市白血病及其主要亚型的流行病学特征和上海市市区1973年至2012年的白血病发病趋势,为探寻病因学研究线索,制定和评估白血病预防、研究与控制的规划和措施提供依据。方法:根据上海市恶性肿瘤病例报告登记系统收集的白血病发病资料,描述患者的发病概况及性别、年龄和各亚型分布,并应用Joinpoint 统计软件进行趋势分析,估算总体和分阶段的年度变化百分比(annual percent change,APC)。标化率采用世界人口构成为标准。结果:2008年至2012年,上海全市共新诊断白血病病例4 404例,占所有部位恶性肿瘤的1.53%。男、女性的白血病粗发病率分别为6.78/10万和5.75/10万,标化发病率为5.14/10万和4.11/10万,男性标化发病率高于女性(X=3.16,P<0.01)。急性髓细胞白血病(acute myelogenous leukemia,AML)是最常见的白血病亚型,占18.30%,其次为急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)、慢性髓细胞白血病(chronic myelocytic leukemia,CML)和慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)。除ALL外,各亚型白血病的年龄别发病率均随着年龄的增长而升高;ALL的发病年龄相对较早,年龄别发病率表现出随年龄的增长发病率下降,0~5岁组是发病高峰。1973年至2012年期间的总白血病标化发病率,男性无明显变化趋势,而女性标化发病率则明显下降,APC为-0.39%;不同亚型的发病趋势不同,男性ALL的发病率上升(APC为1.12%),男性和女性CLL的发病率均呈明显上升趋势,而男、女性AML的发病率则在这40年间均显著下降,平均APC分别为-2.04%和-2.00%。结论:上海白血病发病率接近全球平均水平,男性比女性多发,AML是最常见的亚型,ALL的发病年龄相对较早。1973年至2012年期间,男性白血病发病率无明显变化,女性则显著下降,不同亚型变化趋势不同。

本文引用格式

鲍萍萍, 吴春晓, 张敏璐, 顾凯, 向詠梅, 彭鹏, 龚杨明, 施亮, 邹珍 . 上海市白血病主要亚型发病特征和趋势分析[J]. 诊断学理论与实践, 2017 , 16(05) : 484 -491 . DOI: 10.16150/j.1671-2870.2017.05.007

Abstract

Objective: To describe the patterns of leukemia incidence in Shanghai during 2008-2012 and investigate the trends of leukemia incidence in Shanghai urban area during 1973-2012 in order to provide references for designing prevention programs, research spots and control strategies on leukemia. Methods: Data of leukemia cases were collected by the Shanghai Cancer Registry. The patterns of leukemia incidence according to gender, age, and subtypes during 2008-2012 were described. Joinpoint software was used to analyze the incidence trends, and the annual percentage changes (APCs) for the whole period and time segments were estimated. The world standard population 1960 was used for calcula-ting the age-standardized incidence(ASR). Results: During 2008-2012, 4 404 new leukemia cases were diagnosed in Shanghai, accounted for 1.53% of the total cancer cases. The crude rate of leukemia was 6.78 per 100 000 for male and 5.75 per 100 000 for female, and the ASRs were 5.14 per 100 000 and 4.11 per 100 000, respectively. ASR for total leukemia in male were higher than that in female(X=3.16, P<0.01). Acute myeloid leukemia (AML) was the major subtype of leukemia, accounted for 18.30% of the total cases, then were the acute lymphoblastic leukemia (ALL), chronic myelocy-tic leukemia (CML) and chronic lymphocytic leukemia (CML). Differed from other subtypes, acute lymphoblastic leukemia (ALL) usually occurred among young population, with the highest incidence in 0-5 age group. The incidence of other types of leukemia increased with the increase in age. During the period of 1973-2012, leukemia incidence among males was stable, while the incidence significantly decreased among females with an APC-0.39%. Incidence of ALL increased signi-ficantly among males(APC 1.12%) and remained stable among females. Incidence of CLL increased significantly in both sex, and incidence of AML decreased significantly in females. Conclusions: The incidence of leukemia in Shanghai during 2008-2012 is similar to the average level in the world, and incidence in male is higher than that in female. AML is the major subtype of leukemia. The incidence trends varies with different subtypes. During 1973-2012, incidence of leukemia in male is stable, while decreases significantly in female. The trends differ between different subtypes.

参考文献

[1] Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide:IARC CancerBase No. 11[DB/OL].2017-01-07[2017-08-25] Lyon, France:International Agency for Research on Cancer,2013.http://globocan.iarc.fr.
[2] Linet MS, Devesa SS, Morgan GJ.The leukemias[M]. 3rd. New York: Oxford University Press,2006:841-871.
[3] 刘玉琴, 赵凤菊, 陈万青, 等. 中国2009年白血病发病和死亡资料分析[J]. 中国肿瘤,2013,22(7):528-534.
[4] 陈万青, 单保恩, 郑荣寿, 等. 2003—2007年中国肿瘤登记地区白血病发病与死亡分析[J]. 肿瘤,2012,32(4):251-255.
[5] 王慧文, 潘秀丹. 沈阳市城区白血病流行病学现况分析[J]. 中国慢性病预防与控制,2005,13(4):163-165.
[6] Thygesen LC, Nielsen OJ, Johansen C.Trends in adult leukemia incidence and survival in Denmark, 1943-2003[J]. Cancer Causes Control,2009,20(9):1671-1680.
[7] Xie Y, Davies SM, Xiang Y, et al.Trends in leukemia incidence and survival in the United States (1973-1998)[J]. Cancer,2003,97(9):2229-2235.
[8] Novak I, Jaksić O, Kulis T, et al. Incidence and mortality trends of leukemia and lymphoma in Croatia, 1988-2009[J]. Croat Med J,2012,53(2):115-123.
[9] McNally RJ, Roman E, Cartwright RA. Leukemias and lymphomas: time trends in the UK, 1984-93[J]. Cancer Causes Control,1999,10(1):35-42.
[10] Jin F, Devesa SS, Zheng W, et al.Cancer incidence trends in urban Shanghai, 1972-1989[J]. Int J Cancer,1993,53(5):764-770.
[11] 吴凡, 卢伟, 李德録, 等. 上海市恶性肿瘤登记报告工作的调整与完善[J]. 中国肿瘤,2002,11(6):316-318.
[12] 全国肿瘤防治研究办公室,卫生部卫生统计信息中心,全国肿瘤登记中心. 中国肿瘤登记工作指导手册[M]. 北京: 中国协和医科大学出版社,2004.
[13] Parkin DM, Chen VW, Ferlay J, et al.Comparability and Quality Control in Cancer Registration. IARC Technical Report No 19[M]. Lyon: IARC Press,1994.
[14] 高玉堂, 卢伟. 上海市区恶性肿瘤发病率、死亡率和生存率: 1973~2000[M]. 上海:第二军医大学出版社,2007.
[15] Waterhouse J.Cancer incidence in five continents[M]. Lyon:IARC Press,1976:456.
[16] Estève J, Benhamou E, Raymond L.Statistical methods in cancer research. Volume IV. Descriptive epidemiology[J]. IARC Sci Publ,1994,(128):1-302.
[17] Kim HJ, Fay MP, Feuer EJ, et al.Permutation tests for joinpoint regression with applications to cancer rates[J]. Stat Med,2000,19(3):335-351.
[18] International Agency for research on Cancer. GLOBOCAN 2012: estimated cancer incidence,mortality and prevalence worldwide in 2012[R]. World Health Organization,2016.
[19] Katz AJ, Chia VM, Schoonen WM, et al.Acute lymphoblastic leukemia: an assessment of international incidence, survival, and disease burden[J]. Cancer Causes Control,2015,26(11):1627-1642.
[20] Terwilliger T, Abdul-Hay M.Acute lymphoblastic leukemia: a comprehensive review and 2017 update[J]. Blood Cancer J,2017,7(6):e577.
[21] Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017[J]. CA Cancer J Clin,2017,67(1):7-30.
[22] Lenartova A, Johannesen TB, Tjønnfjord GE.National trends in incidence and survival of chronic lymphocytic leukemia in Norway for 1953-2012: a systematic analysis of population-based data[J]. Cancer Med,2016,5(12):3588-3595.
[23] Olafsson GB, Steingrimsdottir H, Vidarsson B, et al.Chronic lymphocytic leukemia in Iceland from 2003 to 2013: Incidence, presentation and diagnosis[J]. Laeknabladid,2016,102(4):171-177.
[24] Deschler B, Lübbert M.Acute myeloid leukemia: epidemiology and etiology[J]. Cancer,2006,107(9):2099-2107.
[25] Chen Y, Wang H, Kantarjian H, et al.Trends in chronic myeloid leukemia incidence and survival in the United States from 1975 to 2009[J]. Leuk Lymphoma,2013,54(7):1411-1417.
[26] Smith A, Howell D, Patmore R, et al.Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network[J]. Br J Cancer,2011,105(11):1684-1692.
[27] Daniels RD, Schubauer-Berigan MK.A meta-analysis of leukaemia risk from protracted exposure to low-dose gamma radiation[J]. Occup Environ Med,2011,68(6):457-464.
[28] Khalade A, Jaakkola MS, Pukkala E, et al.Exposure to benzene at work and the risk of leukemia: a systematic review and meta-analysis[J]. Environ Health,2010,9:31.
[29] Stenehjem JS, Kjærheim K, Bråtveit M, et al.Benzene exposure and risk of lymphohaematopoietic cancers in 25 000 offshore oil industry workers[J]. Br J Cancer,2015, 112(9):1603-1612.
[30] Turner MC, Wigle DT, Krewski D.Residential pesticides and childhood leukemia: a systematic review and meta-analysis[J]. Cien Saude Colet,2011,16(3):1915-1931.
[31] 陈涛, 黄红, 田英, 等. 室内、外环境因素与儿童白血病关系的研究进展[J]. 环境与职业医学,2009,26(1):89-92.
[32] Wong O, Harris F, Yiying W, et al.A hospital-based case-control study of acute myeloid leukemia in Shanghai: analysis of personal characteristics, lifestyle and environmental risk factors by subtypes of the WHO classification[J]. Regul Toxicol Pharmacol,2009,55(3):340-352.
[33] Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2014[D/OL]. National Cancer Institute. Bethesda, MD.2016-11-01[2017-08-25] https://seer.cancer.gov/csr/1975_2014/.
[34] Chen W, Zheng R, Baade PD, et al.Cancer statistics in China, 2015[J]. CA Cancer J Clin,2016,66(2):115-132.
[35] Laros-van Gorkom BA, Huisman CA, Wijermans PW, et al. Experience with alemtuzumab in treatment of chronic lymphocytic leukaemia in the Netherlands[J]. Neth J Med,2007,65(9):333-338.
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