Epidemiology of Marginal Zone Lymphoma

描述（由申请人提供）： 非霍奇金淋巴瘤分类的显著改进为研究常见亚型边缘区淋巴瘤（MZL）的病因、预防和病程提供了难得的机会。我们建议（1）病例对照研究和（2）KP人群中的病例系列。我们将在1996年至2003年6月期间诊断的KP成员中确定250例MZL病例。一般KP人群的随机样本将被确定为对照组，以实现1：1的病例对照比。将从病历和计算机化数据库中获取信息。具体目标如下： 1.我们将探讨慢性感染性和炎症性疾病史增加MZL风险的假设。 2.我们将获得初步数据，以评估（a）病理诊断的质量和（B）病例和对照组中既往病史的患病率，用于未来的大规模流行病学研究。 3.在这些病例中，我们将描述MZL的病程和管理，以描述预后并确定未来临床研究的领域。 该研究的主要优势是基于人群的设置和对MZL的关注。此外，该图表是关于医疗暴露、病程和疾病管理的前瞻性信息的高度准确和完整的来源。预计75%的病例在诊断前将在健康计划中登记10年或更长时间，医疗记录中有相应的完整信息。这项拟议的研究将探索重要的假设，提供开展大规模研究所需的试点数据，确定预后因素，为患者和提供者提供做出生活方式和治疗决策所需的关键信息，并检查护理的变化，以关注未来的临床研究。

DESCRIPTION (provided by applicant): Dramatic improvements in the classification of non-Hodgkin's lymphoma create an exceptional opportunity to investigate the causes, prevention, and course of a common subtype, marginal zone lymphoma (MZL). We propose (1) a case-control study and (2) a case series set in the KP population. We will identify 250 cases of MZL among KP members diagnosed during the period 1996 through June, 2003. A random sample of the general KP population will be identified as a control group to achieve a case-control ratio of 1:1. Information from the medical record and computerized databases will be obtained. The specific aims are as follows: 1. We will explore hypotheses that a history of chronic infectious and inflammatory diseases increases the risk of MZL. 2. We will obtain pilot data to assess (a) the quality of the pathologic diagnosis and (b) the prevalence of past medical history in cases and controls for a future, large-scale epidemiologic study. 3. Among the cases, we will describe the course and management of MZL to characterize prognosis and identify areas for future clinical research. The key strengths of the study are the population-based setting and the focus on MZL. In addition, the chart is a highly accurate and complete source of prospective information on medical exposures, disease course, and disease management. It is anticipated that 75% of the cases will have 10 years or longer enrollment in the health plan preceding their diagnosis, with correspondingly complete information in the medical record. The proposed study will explore important hypotheses, provide pilot data needed to develop a large-scale study, identify prognostic factors to give patients and providers the crucial information they need to make lifestyle and treatment decisions, and examine variation in care to focus future clinical research.