Distribution Characteristics Of Lymphoma In Southern Hunan Based On The New Classification Of WHO(2016)

Objective:According to the WHO(2016)new classification criteria for lymphatic hematopoietic system,the distribution characteristics,trends and causes of lymphoma in southern Hunan in the past 10 years were analyzed to provide scientific and objective basis for pathological diagnosis and clinical treatment of malignant lymphatic hematopoiesis in southern Hunan.Methods:A unified questionnaire was used to collect information onthe gender,age,location,clinicalcharacteristics and histomorphological characteristics of patients with lymphoma diagnosed in our department from 2007 to 2017.After initial judgment of HE morphology of the section,the corresponding antibodies was used to detect the expression of these antibodies in the tissues,such as CD45?CD3?CD8?CD20?CD21?CD30?CD34?CD38?CD56?ALK?Bcl-2?MPO?TDT?TIA-1?Cyclin D-1?Ki-67 and so on?Necessary cases were also carried out EBER?TCR gene rearrangement testing,or digital pathology remote consultation,In order to diagnosis of auxiliary cases or differential diagnosis,and statistical analysis of the above results.Results:1.Distribution characteristics of subtypes:Between 2007 and 2017,1149 patients were diagnosed as having malignant lymphoid hematopoietic tumors in our institution?In all lymphomas,non-Hodgkin's lymphoma accounted for 1033 cases?Diffuse large B-cell lymphoma is located in the first place of the subtype of B-cell lymphoma in southern Hunan,followed by the mucosa-associated lymph node extranodal marginal zone lymphoma;NK/T-cell lymphoma lymphoma subtype of the first case of extranodal NK/T cell lymphoma(nasal);However,The number of Hodgkin's lymphoma diagnosis(a total of 55cases)less than normal,Hodgkin's lymphoma in southern Hunan is dominated by mixed cell types.There are 61 cases of lymphoma can not be classified because of too little tissue diagnosis.2.Distribution characteristics of gender:the incidence of lymphoma in southern Hunan male than female.Diffuse large B-cell lymphoma predominates in the subtype among men.Extranodal NK/T-cell lymphoma(nasal type)and mucosa-associated lymphoid tissue extranodal marginal zone lymphoma ranked second.Lymphoma subtype is still dominated by diffuse large B-cell lymphoma among women,followed by mucosa-associated lymph node extranodal marginal zone lymphoma.3.Distribution characteristics of age and time period:When the age less than or equal to 50 years old,the incidence of lymphoma in southern Hunan were diffuse large B-cell lymphoma,Hodgkin's lymphoma,extranodal NK/T-cell lymphoma(nasal type)and mucosa-associated lymphoid tissue Extranodal marginal zone lymphoma.;While older than50 years old,the order of incidence of lymphoma in southern Hunan was diffuse large B-cell lymphoma,mucosa-associated lymphoid tissue extranodal marginal zone lymphoma and extranodal NK/T cell lymphoma(nasal type);And the incidence of lymphoma in the past ten years has obviously risen.4.Distribution characteristics of occurrence site:Southern Hunan lymphoma occurred in a few cases of lymph nodes was significantly more than lymph node outside.Cervical lymph node,inguinal lymph node and axillary lymph node are the predilection sites in lymph nodes;and the digestive tract,nasopharynx,tonsils are the main parts of lymph nodes outside.5.Statistical significance:The chi-square test showed that there was no significant difference in the sex and location of the patients in southern Hunan compared with the national multinocenters(P>0.05).There were significant differences in the distribution of HL and NHL among different regions(X~2=322.051,P<0.001).The results of comparison between groups showed by comparison,compared with southern Hunan province,there were significant differences in HL and NHL between national multicenter centers and UK(X~2,18.353 and 66.533,P<0.001).And the distribution of tumor sites at different ages and the distribution of different types of tumors at different sites were statistically significant(X~2,207.673 and 209.953,P<0.001).Conclusions:According to the new classification standard of lymphatic hematopoietic system in 2016,we analyzed the distribution characteristics and trends of lymphoma in southern Hunan in recent 10 years as follows:1.Distribution characteristics of subtypes:In the 1149 patients with lymphoma in southern Hunan,NHL occupies a major advantage.The number of DLBCL cases of B cell-derived lymphoma is the highest,and it occurs in the cervical lymph nodes.The second is MALT,which occurs in the gastrointestinal tract.T-cell lymphoma accounted for 17.7%of all NHL in southern Hunan,ENKTL significantly surpassed other subtypes and occurred in the nasopharynx.However,the total number of cases of HL was less,which mainly occurred in lymph nodes.2.Distribution characteristics of age?time period and occurrence site:the incidence of lymphoma in southern Hunan has been on an upward trend for the past decade.The peak age of onset is 50 to 70 years old.And the distribution of tumor sites at different ages and the distribution of different types of tumors at different sites are different.3.The distribution of lymphomas in southern Hunan has regional differences.It is similar to the incidence of major lymphoma subtypes in East Asian countries,but it is different from the distribution characteristics of subtypes in Western countries.