CAJ | 학술논문

目的探讨原发性肝脏淋巴瘤(PHL)的临床病理学特点及预后.方法回顾性分析1982年1月至2012年12月经手术切除并经术后病理证实的35例PHL患者的临床和随访资料,对其临床表现、影像学特点、免疫组化分型以及预后进行分析.结果 35例PHL患者中,男25例(71.4％),女10例(28.6％)；平均年龄52.6岁.主要症状为发热、右上腹疼痛和肝占位等.血清乙肝表面抗原阳性21例,血清抗丙肝病毒抗体阳性1例,血清甲胎蛋白水平升高3例,血清CA199水平升高2例,伴有肝硬化12例,伴有肝癌2例.病理分型为弥漫性大B细胞淋巴瘤(DLBCL) 19例(54.3％),T细胞PHL 13例(37.1％),结外黏膜相关组织边缘区淋巴瘤3例(8.6％).32例患者行手术切除加术后辅助治疗.DLBCL患者的术后生存时间为(31.7±3.2)个月,明显长于T细胞PHL患者[(22.9±2.2)个月,P＜0.05].结论 PHL的发生可能与乙型肝炎病毒的感染有关,手术切除加辅助治疗是PHL的主要治疗模式,PHL的预后与病理分型有关.
목적 탐토원발성간장림파류(PHL)적림상병이학특점급예후.방법 회고성분석1982년1월지2012년12월경수술절제병경술후병리증실적35례PHL환자적림상화수방자료,대기림상표현、영상학특점、면역조화분형이급예후진행분석.결과 35례PHL환자중,남25례(71.4％),녀10례(28.6％)；평균년령52.6세.주요증상위발열、우상복동통화간점위등.혈청을간표면항원양성21례,혈청항병간병독항체양성1례,혈청갑태단백수평승고3례,혈청CA199수평승고2례,반유간경화12례,반유간암2례.병리분형위미만성대B세포림파류(DLBCL) 19례(54.3％),T세포PHL 13례(37.1％),결외점막상관조직변연구림파류3례(8.6％).32례환자행수술절제가술후보조치료.DLBCL환자적술후생존시간위(31.7±3.2)개월,명현장우T세포PHL환자[(22.9±2.2)개월,P＜0.05].결론 PHL적발생가능여을형간염병독적감염유관,수술절제가보조치료시PHL적주요치료모식,PHL적예후여병리분형유관.
Objective To evaluate the clinicopathological features and prognosis of primary hepatic lymphoma (PHL).Methods Thirty-five patients with PHL who underwent surgical resection and were confirmed by pathology in our hospital from 1982 to 2012 were re-evaluated for clinicopathological data,including their symptoms,radiological features,recurrence interval,histopathological properties and prognosis.Results Of the 35 patients,25 were men (71.4％) and 10 were women(28.6％),with an average age of 52.6 years old (range,17-79 years).Presented symptoms were epigastric phymatosis,abdominal pain and low-grade fever.In the present study,21 (60.0％) patients were positive for HBsAg,1 (2.9％) patient was positive for anti-HCV,3 patients were positive for AFP,12 patients and 2 patients were complicated by cirrhosis and hepatocellular carcinoma,respectively.Pathologically,35 PHL were classified into 19 DLBCL (54.3％),13 T cell-lymphoma (37.1％),and 3 MALT lymphoma (8.6％).Patients with DCBCL showed better postoperative survival than patients with T cell-lymphoma (31.7 ± 3.2) months vs.(22.9 ± 2.2) months (P ＜ 0.05).Conclusions Hepatitis B vivus (HBV) infection may contribute to the pathogenesis of Chinese patients with PHL.Surgical resection followed by comprehensive therapy is the first-line option for PHL.The prognosis of patients with PHL is associated with PHL subtypes.