Incidence of lymphoid neoplasms among atomic bomb survivors by histological subtype, 1950 to 1994
Incidence of lymphoid neoplasms among atomic bomb survivors by histological subtype, 1950 to 1994
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DOI：
10.1182/blood.2020010475
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发表时间：
2022-01-14
期刊：
影响因子：
20.3
通讯作者：
Mabuchi, Kiyohiko
中科院分区：
文献类型：
--
作者：
Fujihara, Megumu;Sakata, Ritsu;Mabuchi, Kiyohiko
流行病学数据提供了有限和不一致的证据，证明辐射暴露与淋巴细胞肿瘤之间的关系。我们将1950年至1994年间在原子弹幸存者寿命研究队列中诊断的553例淋巴肿瘤病例分类为世界卫生组织亚型。成熟b细胞肿瘤占58%，成熟t细胞和自然杀伤（NK）细胞肿瘤占20%，前体细胞肿瘤占5%，霍奇金淋巴瘤（HL）占3%，其余15%被归类为非霍奇金淋巴瘤（NHL）肿瘤或未另行说明的淋巴样肿瘤。我们使用泊松回归方法来评估辐射暴露与更常见亚型之间的关系。在早期的报告中，NHL肿瘤作为一个群体，在男性中有显著的剂量反应，而在女性中没有。然而，亚型分析显示，辐射剂量与前体细胞新质率的增加密切相关，在50岁时，估计每Gy的超额相对风险为16（95%置信区间：7.0,bbb533）。目前主要基于组织诊断的数据表明，辐射剂量与淋巴样肿瘤之间的关联主要是由对前体细胞肿瘤的辐射效应驱动的，而没有证据表明辐射剂量对主要类别的成熟细胞肿瘤(B细胞或T细胞/ nk细胞，或更具体的疾病实体（弥漫性大B细胞淋巴瘤、浆细胞骨髓瘤、成人T细胞白血病/淋巴瘤）或HL有反应。
Epidemiological data have provided limited and inconsistent evidence on the relationship between radiation exposure and lymphoid neoplasms. We classified 553 lymphoid neoplasm cases diagnosed between 1950 and 1994 in the Life Span Study cohort of atomic bomb survivors into World Health Organization subtypes. Mature B-cell neoplasms represented 58%, mature T-cell and natural killer (NK)-cell neoplasms 20%, precursor cell neoplasms 5%, and Hodgkin lymphoma (HL) 3%, with the remaining 15% classified as non-Hodgkin lymphoid (NHL) neoplasms or lymphoid neoplasms not otherwise specified. We used Poisson regression methods to assess the relationship between radiation exposure and the more common subtypes. As in earlier reports, a significant dose response for NHL neoplasms as a group was seen for males but not females. However, subtype analyses showed that radiation dose was strongly associated with increased precursor cell neo-plasms rates, with an estimated excess relative risk per Gy of 16 (95% Confidence interval: 7.0, >533) at age 50. The current data based primarily of tissue-based diagnoses suggest that the association between radiation dose and lymphoid neoplasms as a group is largely driven by the radiation effect on precursor cell neoplasms while presenting no evidence of a radiation dose response for major categories of mature cell neoplasms, either B- or T-/NK-cell, or more specific disease entities (diffuse large B-cell lymphoma, plasma cell myeloma, adult T-cell leukemia/lymphoma) or HL.