Incidence and Mortality Trends and Risk Prediction Nomogram for Extranodal Diffuse Large B-Cell Lymphoma: An Analysis of the Surveillance, Epidemiology, and End Results Database
Incidence and Mortality Trends and Risk Prediction Nomogram for Extranodal Diffuse Large B-Cell Lymphoma: An Analysis of the Surveillance, Epidemiology, and End Results Database
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结外弥漫性大 B 细胞淋巴瘤的发病率和死亡率趋势以及风险预测列线图：监测、流行病学和最终结果数据库的分析
DOI：
10.3389/fonc.2019.01198
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发表时间：
2019-11-12
影响因子：
4.7
通讯作者：
Hu, Yu
中科院分区：
文献类型：
--
作者：
Yin, Xuejiao;Xu, Aoshuang;Hu, Yu
背景：DLBCL是最常见的非霍奇金淋巴瘤，可见于各种结外部位。但对结外DLBCL的特殊趋势知之甚少。方法：共有15,882名结外DLBCL患者纳入监测、流行病学和最终结果(SEER)数据库(1973-2015)的发病率分析。用连接点回归软件计算年变化率(APC)。用R软件建立诺模图预测总生存期(OS)。结果：在研究期间，结外DLBCL的发病率以每年1.6%(95%可信区间，0.42.8，p<；0.001)的速度持续上升，直到2003年左右有所下降。结外DLBCL的发病率死亡率趋势与此相似，大约在1993年出现下降。从20世纪70年代到2010年代，5年生存率显著提高(44.15%比63.7%)，最明显的增加发生在原发于头/颈部的DLBCL患者。C指数显示OS值为0.708，这验证了诺模图的良好表现，并能够预测结外DLBCL患者的预后。校准曲线显示，1、5和10年总生存率的真实值和预测值之间分别具有令人满意的一致性。结论：结外DLBCL的发病率和基于发病率的死亡率几十年来一直在增加，近年来又有下降的趋势。这些发现可能有助于科学家识别与疾病相关的风险因素，并更好地管理疾病。预测签名云确定了应该接受有效治疗以防止这种疾病的致命性质的高危患者，以及减少过度治疗的低风险患者。
Background: DLBCL is the most commonly occurring type of non-Hodgkin's lymphoma, which may be found at various extranodal sites. But little is known about the particular trends of extranodal DLBCL. Methods: A total of 15,882 extranodal DLBCL patients were included in incidence analysis from the Surveillance, Epidemiology, and End Results (SEER) database (1973–2015). The joinpoint regression software was used to calculate the annual percent change (APC) in rates. Nomograms were established by R software to predict overall survival (OS). Results: The extranodal DLBCL incidence continued to rise at a rate of 1.6% (95% CI, 0.4–2.8, p < 0.001) per year over the study period, until it declined around 2003. The incidence-based mortality trend of extranodal DLBCL had a similar pattern, with a decrease happening around 1993. Five-year survival rates improved dramatically from the 1970s to 2010s (44.15 vs. 63.7%), and the most obvious increase occurred in DLBCL patients with primary site in the head/neck. The C-index showed a value for OS of 0.708, which validated the nomograms performed well and were able to forecast the prognosis of patients with extranodal DLBCL. The calibration curves showed satisfactory consistency between true values and predicted values for 1-, 5-, and 10-year overall survival, respectively. Conclusions: The incidence and incidence-based mortality of extranodal DLBCL had been increasing for decades, followed by a promising downward trend in recent years. These findings may help scientists identify disease-related risk factors and better manage the disease. The prediction signature cloud identifies high-risk patients who should receive effective therapies to prevent the fatal nature of this disease, and low-risk patients to reduce over-treatment.