한국의 악성 림프종에 관한 통계적 관찰

Abstract

Background: The disorder classified as malignant lymphoma are increasing in frequency in Korea and there have been numerous advances in our understanding of the pathophysiology of these disorders and in their treatment. There are considerable geographic and ethnic differences in the incidence, age distribution, histopathologic types of the malignant lymphoma.

Methods: We analyzed clinical findings of malignant lymphoma patients in Korea for 5 years. Sixteen hundred and fifty-three cases of the malignant lymphoma, which were collected from the departments of internal medicine of 23 general hospitals and university hospitals and department of pediatrics of one university hospital throughout Korea, were summarized and reviewed. The data collected comprised of the cases for 5 years from January 1989 to December 1993.

Results : 1) There were 142 cases of Hodgkin disease(8.6%), and 1,511 cases of non-Hodgkin lymphoma(91.4%) with 1 : 11 ratio.

2) The most common histopathologic type of Hodgkin disease was mixed cellularity(54.2%), and that of non-Hodgkin lymphoma was diffuse, large cell type (50.9%), respectively.

3) Peripheral lymphadenopathy was the most common presenting symptoms at the time of first visit to the hospital, especially in Hodgkin disease.

4) High proportion of lymphomas(43.1% of total cases: 12.6% of Hodgkin disease and 46.3% of non-Hodgkin lymphoma) involved the extranodal sites. The most common site was gastro-intestinal system(16.7%).

5) In treatment responses, the complete remission rate was 69.1% in Hodgkin disease and 55.0% in non-Hodgkin lymphoma, respectively, and 13.8% of Hodgkin disease and 22.0% of non-Hodgkin lymphoma were relapsed. We observed the statistically significant difference in survival duration between Hodgkin disease and non-Hodgkin lymphoma.

6) According to multivariate analysis, age, B-symptom, stage, LDH and number of extranodal sites were the useful prognostic factors predicting survival.

Conclusion : The characteristics of malignant lymphoma in Korea differ from those in the western countries with respect to the frequency of histopathologic pattern. The epidemiologic studies are necessary for the clarification of these differences.