The Scotland and Newcastle epidemiological study of Hodgkin's disease: impact of histopathological review and EBV status on incidence estimates
The Scotland and Newcastle epidemiological study of Hodgkin's disease: impact of histopathological review and EBV status on incidence estimates
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DOI：
10.1136/jcp.56.11.811
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发表时间：
2003-11-01
影响因子：
3.4
通讯作者：
Alexander, FE
中科院分区：
文献类型：
--
作者：
Jarrett, RF;Krajewski, AS;Alexander, FE
目的：霍奇金淋巴瘤(HL)的流行病学和病理学特征复杂。爱泼斯坦-巴尔病毒(EBV)一直与一定比例的病例有关，这些病例被认为代表了HL的一个独特的病因学亚群。本分析的目的是利用一项基于人群的研究--苏格兰和纽卡斯尔霍奇金氏病流行病学研究(SNEHD)的数据，分别分析EBV相关性和非相关性HL的年龄和性别特定发病率。本研究还提供了一个独特的机会来评估当前HL诊断和分类的准确性。方法：SNEHD分析了1993-1997年间在研究区连续诊断的HL病例。检索诊断活检材料，确定肿瘤的EBV状态，并进行组织学复习。结果：共有622例符合研究条件，其中537例进行EBV检查，549例进行组织病理学复习。HL的总体诊断和结节硬化性HL分型的准确性较好，但老年HL的诊断和其他亚型的分型可靠性较差。1/3的典型HL病例与EBV相关，且EBV相关和非相关病例的年龄别发病率曲线存在差异。结论：EBV相关性和非相关性HL的年龄别发病率曲线比较支持这一假设，即这是两种不同的病因。霍奇金淋巴瘤诊断的准确性总体上是好的，但某些亚组病例仍然存在诊断困难。
Aims: The epidemiological and pathological features of Hodgkin lymphoma (HL) are complex. The Epstein-Barr virus (EBV) is consistently associated with a proportion of cases, and these cases are thought to represent a distinct aetiological subgroup of HL. The aim of the present analysis was to determine the age and sex specific incidence of EBV associated and non-associated HL, analysed separately, using data derived from a population based study - the Scotland and Newcastle epidemiological study of Hodgkin's disease (SNEHD). This study also provided a unique opportunity to evaluate accuracy in the current diagnosis and classification of HL.Methods: SNEHD analysed consecutive cases of HL diagnosed in the study area between 1993 and 1997. Diagnostic biopsy material was retrieved, EBV status of tumours was determined, and histological review was performed.Results: In total, 622 cases were eligible for the study, and EBV studies and histopathological review were performed on biopsy material from 537 and 549 cases, respectively. Accuracy in the overall diagnosis of HL and classification of nodular sclerosis HL was good, but diagnosis of HL in the elderly and classification of other subtypes was less reliable. One third of classic HL cases were EBV associated, and age specific incidence curves for EBV associated and non-associated cases were distinct.Conclusions: Comparison of age specific incidence curves for EBV associated and non-associated HL supports the hypothesis that these are two distinct aetiological entities. Accuracy in the diagnosis of HL is generally good, but certain subgroups of cases continue to present diagnostic difficulties.