CAJ | 학술논문

[目的]探讨原发性皮肤B细胞淋巴瘤(PCBCL)的高发年龄、临床特点、治疗方法及影响预后的因素.[方法]1970年1月至2010年9月间天津市肿瘤登记中心共记录PCBCL 31例,其中26例临床资料完整.收集该26例患者的性别、年龄、首发部位、病变范围、病理类型、转移部位、治疗方法、生存期等资料并分析预后相关因素.数据采用SPSS 16.0统计软件包处理,生存分析采用Kaplan-Meier法,单因素预后分析采用Log-rank检验,多因素预后分析采用Cox比例风险模型,运用Forward LR法对变量进行筛选.[结果]1970-2010年间资料完整的PCBCL 26例,临床表现不典型；病理类型以原发性皮肤滤泡中心淋巴瘤(12例)和原发性皮肤边缘带B细胞淋巴瘤(8例)最为常见,其次是原发性皮肤弥漫大B细胞淋巴瘤,腿型(4例).随访显示,8例出现淋巴结受累,其中颈部4例,腹股沟4例；3例出现脏器受累,包括肺及胸膜1例、骨髓1例和中枢神经系统1例；多数患者经手术切除联合化疗或放化疗,5年生存率为80.8％.统计分析显示,病理类型、乳酸脱氢酶、球蛋白与预后有关,而性别、年龄、首发部位、病变范围、内脏的受累、B症状、治疗方法、复发次数、β2微球蛋白、血红蛋白、淋巴细胞绝对值与预后无关.[结论]PCBCL是一组罕见的结外淋巴瘤,高发年龄为39～66岁；临床表现不典型；5年生存率为80.8％；病理类型、乳酸脱氢酶、球蛋白与预后相关.
[목적]탐토원발성피부B세포림파류(PCBCL)적고발년령、림상특점、치료방법급영향예후적인소.[방법]1970년1월지2010년9월간천진시종류등기중심공기록PCBCL 31례,기중26례림상자료완정.수집해26례환자적성별、년령、수발부위、병변범위、병리류형、전이부위、치료방법、생존기등자료병분석예후상관인소.수거채용SPSS 16.0통계연건포처리,생존분석채용Kaplan-Meier법,단인소예후분석채용Log-rank검험,다인소예후분석채용Cox비례풍험모형,운용Forward LR법대변량진행사선.[결과]1970-2010년간자료완정적PCBCL 26례,림상표현불전형；병리류형이원발성피부려포중심림파류(12례)화원발성피부변연대B세포림파류(8례)최위상견,기차시원발성피부미만대B세포림파류,퇴형(4례).수방현시,8례출현림파결수루,기중경부4례,복고구4례；3례출현장기수루,포괄폐급흉막1례、골수1례화중추신경계통1례；다수환자경수술절제연합화료혹방화료,5년생존솔위80.8％.통계분석현시,병리류형、유산탈경매、구단백여예후유관,이성별、년령、수발부위、병변범위、내장적수루、B증상、치료방법、복발차수、β2미구단백、혈홍단백、림파세포절대치여예후무관.[결론]PCBCL시일조한견적결외림파류,고발년령위39～66세；림상표현불전형；5년생존솔위80.8％；병리류형、유산탈경매、구단백여예후상관.
[Objective] To assess the predilection age,clinical features,treatment and pognostic factors of primary cutaneous B-cell lymphoma (PCBCL).[Methods] A total of 31 patients with PCBCL were registered in Tianjin Cancer Central Registry from January 1970 to September 2010,and 26 patients had complete medical recortds.A retrospective analysis was conducted on the 26 patients.The following indices were analyzed,including gender,age,body sites of initial involvement,extent of cutaneous involvement,pathological subtypes,metastatic sites,treatment,survival and prognosis.Data were processed with SPSS16.0 software,survival analysis was carried out by using Kaplan-Meier method,univariate analysis of prognostic factors by Log-rank test,multivariate analysis of prognostic faetors by COX proportional hazards model,and variables were selected by Forward LR method.[Results] Clinical manifestafions were atypical in these patients.The ratio of man and women was 1:1.6.Of the 26 cases,12 were primary cutaneous follicle-center lymphoma (PCFCL),8 were primary cutaneous marginal zone lymaphoma (PCMZL),and 4 were PCLBCL,leg type.Follow-up revealed lymph node involvement in 8 patients (4 in cervical nodes and 4 in inguinal nodes),distant metastasis of organs in 3 patients ( 1 in lung and pleura,1 in bone marrow and 1 in central nervous system).Most patients received surgical treatment combined with chemotherapy or chemoradiation.The 5-year overall survival rate was 80.8％(21/26).Statistical analysis showed that the prognosis of PCBCL was associated with histological subtype,lactate dehydrogenase (LDH) level and globulin level,but unrelated to gender,age,site of initial involvement,extent of cutaneous involvement,involvement of lymph nodes and organs,presence of B symptoms,treatment strategies,number of relapses,level of β2-globulin and hemoglobin,or lymphocyte absolute value.[Conclusion]s PCBCL,as a kind of rare extra-nodal lymphoma,usually occurs with atypical clinical mainfestations in persons aged from 39 to 66 years.The 5-year overall survival rate was 80.8％ in these patients.The prognosis of PCBCL seems to be related to histological subtypes,LDH and globulin levels.