CAJ | 학술논문

目的：探讨儿童非霍奇金淋巴瘤( NHL)临床特点及预后相关因素。方法选取本院收治的NHL患儿63例,按照WHO淋巴瘤分型标准进行诊断,根据不同免疫标记、病理分型、临床分期进行化疗。采用Kaplan-Meier法进行生存分析,不同临床因素的生存率比较采用卡方检验。结果 T淋巴细胞母细胞淋巴瘤(T-LBL)19例(30%),B 淋巴细胞母细胞淋巴瘤(B-LBL)5例(7.9%),Burkitt’s 淋巴瘤(BL)16例(25.4%),弥漫性大B细胞淋巴瘤(DLBCL)9例(14.3%),滤泡性淋巴瘤(FL)1例(1.6%),黏膜相关性淋巴组织淋巴瘤(MALT)1例(1.6%),间变大细胞性淋巴瘤(ALCL)5例(7.9%),外周T细胞淋巴瘤-非特异型(PTCL-NOS)2例(3.2%),皮下脂膜炎样 T细胞淋巴瘤(SPTCL)2例(3.2%),NK/T 细胞淋巴瘤2例(3.2%),系统性EBV+儿童T细胞淋巴组织增殖性疾病(CSEBV+T-LPD)1例(1.6%)。Ⅰ期3例(4.8%),Ⅱ期7例(11.1%),Ⅲ期18例(28.6%),Ⅳ期35例(55.6%)。1年总生存率(OS)为80.95%,3年OS为73.02%。3年无复发生存率(RFS)为68.85%,5年RFS为66.13%。单因素分析提示存在中枢神经系统浸润及血LDH升高影响预后。结论儿童NHL不同病理类型的预后存在差异。应根据病理诊断、临床分期及各种危险因素的评估,实施不同强度和疗程的化疗方案,以达到更好治疗效果。
목적：탐토인동비곽기금림파류( NHL)림상특점급예후상관인소。방법선취본원수치적NHL환인63례,안조WHO림파류분형표준진행진단,근거불동면역표기、병리분형、림상분기진행화료。채용Kaplan-Meier법진행생존분석,불동림상인소적생존솔비교채용잡방검험。결과 T림파세포모세포림파류(T-LBL)19례(30%),B 림파세포모세포림파류(B-LBL)5례(7.9%),Burkitt’s 림파류(BL)16례(25.4%),미만성대B세포림파류(DLBCL)9례(14.3%),려포성림파류(FL)1례(1.6%),점막상관성림파조직림파류(MALT)1례(1.6%),간변대세포성림파류(ALCL)5례(7.9%),외주T세포림파류-비특이형(PTCL-NOS)2례(3.2%),피하지막염양 T세포림파류(SPTCL)2례(3.2%),NK/T 세포림파류2례(3.2%),계통성EBV+인동T세포림파조직증식성질병(CSEBV+T-LPD)1례(1.6%)。Ⅰ기3례(4.8%),Ⅱ기7례(11.1%),Ⅲ기18례(28.6%),Ⅳ기35례(55.6%)。1년총생존솔(OS)위80.95%,3년OS위73.02%。3년무복발생존솔(RFS)위68.85%,5년RFS위66.13%。단인소분석제시존재중추신경계통침윤급혈LDH승고영향예후。결론인동NHL불동병리류형적예후존재차이。응근거병리진단、림상분기급각충위험인소적평고,실시불동강도화료정적화료방안,이체도경호치료효과。
Objective To evaluate the clinical characteristics of childhood non-Hodgkin’ s lymphoma and prognostic factors. Method From October 2005 to January 2014,63 children newly diagnosed with NHL were included in the study accordins to the World Health Organization classification of tumors. The chemotherapy regimens were based on immunephenotype、pathological type and clinical stages. The rate of overall survival( OS) and relapse-free survival ( RFS) were analyzed by Kapkn-Meier, The survival rate of different clinical factors were compared using the chi-square test. Result Among 63 cases, 19 cases ( 30%) were T-LBL, 5 cases ( 7. 9%) were B-LBL, 16 cases (25. 4%) were BL,9 cases(14. 3%) were DLBCL,1 case(1. 6%) was FL,1 case(1. 6%) was MALT,5 cases (7. 9%) were ALCL,2 cases(3. 2%) were PTCL-NOS,2 cases(3. 2%) were SPTCL,2 cases(3. 2%) were NK/T cell lymphom,1 case(1. 6%) was CSEBV+T-LPD. 3 cases were divided into stage Ⅰ,7 cases into stage Ⅱ,18 cases into stage Ⅲ and 35 cases into stageⅣ. The Kaplan-Meier estimates of 1-year and 3-year OS were 80. 95%and 73. 02%;the 3-year and 5-year RFS were 68. 85% and 66. 13%. Single factor analysis showed that the involve-ment of central nervous system and high LDH level were the major prognostic factors iniluencing survival. Conclu-sion The prognosis of different pathological types were different in chilldhood NHL. According to the evaluation of clinical stage,various risk factors and pathological diagnosis,implement different intensity and duration of treatment, in order to achieve better results.