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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。
OBJECTIVE: To analyze the epidemiological characteristics of leukemia and its major subtypes in Shanghai from 2008 to 2012 and the trend of leukemia incidence in Shanghai from 1973 to 2012. In order to explore the etiological research clues, to develop and evaluate leukemia prevention and research With the control of planning and measures to provide the basis. Methods: According to the incidence of leukemia data collected by Shanghai Malignant Tumor Case Registration System, the patient’s morbidity, sex, age and subtypes distribution were described. Joinfit statistical software was used to conduct trend analysis to estimate the overall and phased annual changes (annual percent change, APC). Standardization rate using the world population as a standard. Results: From 2008 to 2012, a total of 4 404 new cases of leukemia were diagnosed in Shanghai, accounting for 1.53% of all malignant tumors. The prevalence rates of leukemia in males and females were 6.78 / lakh and 5.75 / lakh, respectively, and the standardized rates were 5.14 / lakh and 4.11 / lakh respectively. The standardized rates of males were higher than those of females (X = 3.16, P < 0.01). Acute myelogenous leukemia (AML) is the most common leukemia subtype, accounting for 18.30%, followed by acute lymphoblastic leukemia (ALL), chronic myelocytic leukemia (CML) and chronic Lymphocytic leukemia (CLL). In addition to ALL, the age-specific morbidity of each subtype of leukemia increased with age; the age of onset of ALL was relatively early, and the age-related morbidity was decreased with age Is the peak incidence. The standardized incidence of total leukemia between 1973 and 2012 showed no significant change trend in males, but the standardized incidence of females was significantly decreased, APC was -0.39%; the incidence of different subtypes was different, the incidence of male ALL increased (APC was 1.12%). The prevalence of CLL in both men and women showed a significant upward trend. However, the incidence of AML in both men and women decreased significantly in these 40 years with an average APC of -2.04% and -2.00%, respectively. Conclusion: The incidence of leukemia in Shanghai is close to the global average. Men are more frequent than women. AML is the most common subtype and the age of onset of ALL is relatively early. Between 1973 and 2012, there was no significant change in the incidence of leukemia in males, but a significant decrease in females, with different trends in different subtypes.