中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
11期
858-862
,共5页
王聪%袁长吉%何华%白鸥
王聰%袁長吉%何華%白鷗
왕총%원장길%하화%백구
淋巴瘤,非霍奇金%病理学,临床%肿瘤分期%国际预后评估指数%预后
淋巴瘤,非霍奇金%病理學,臨床%腫瘤分期%國際預後評估指數%預後
림파류,비곽기금%병이학,림상%종류분기%국제예후평고지수%예후
Lymphoma non-Hodgkin%Pathology,clinical%Neoplasm staging%International prognostic index%Prognosis
目的 探讨原发结外非霍奇金淋巴瘤(PE-NHL)的临床病理特点及预后因素.方法 回顾性分析2007年1月至2011年12月诊治的151例PE-NHL患者的临床资料.结果 PE-NHL占同期收治非霍奇金淋巴瘤的58.8％(151/257),平均发病年龄为52岁,男女之比为1.16∶1.PE-NHL最常累及的结外器官为胃肠道(30.5％)、鼻(19.9％)及Waldeyer环(17.2％),最常见的病理类型为弥漫大B细胞型(55.0％)、NK/T细胞型(18.5％)及黏膜相关结外边缘区B细胞型(13.2％).临床分期为Ⅰ期31例(20.5％),Ⅱ期45例(29.8％),Ⅲ期44例(29.1％),Ⅳ期31例(20.5％).原发于鼻的PE-NHL分期较早,Ⅰ～Ⅱ期占76.7％.结外弥漫大B细胞淋巴瘤(PE-DLBCL)患者的3年生存率为73.2％,3年疾病无进展生存率为46.6％.国际预后评估指数(IPI)可以很好地预测PE-DLBCL的预后.多因素分析结果显示,血沉及首次治疗后疗效为影响PE-DLBCL患者预后的独立因素.结论 PENHL的发病率较高,胃肠道是最常见的受累器官,最常见的病理类型为弥漫大B细胞型.按照IPI评分进行危险分层可以反映PE-DLBCL患者的预后,但仅有血沉及首次治疗后疗效为独立预后指标.
目的 探討原髮結外非霍奇金淋巴瘤(PE-NHL)的臨床病理特點及預後因素.方法 迴顧性分析2007年1月至2011年12月診治的151例PE-NHL患者的臨床資料.結果 PE-NHL佔同期收治非霍奇金淋巴瘤的58.8％(151/257),平均髮病年齡為52歲,男女之比為1.16∶1.PE-NHL最常纍及的結外器官為胃腸道(30.5％)、鼻(19.9％)及Waldeyer環(17.2％),最常見的病理類型為瀰漫大B細胞型(55.0％)、NK/T細胞型(18.5％)及黏膜相關結外邊緣區B細胞型(13.2％).臨床分期為Ⅰ期31例(20.5％),Ⅱ期45例(29.8％),Ⅲ期44例(29.1％),Ⅳ期31例(20.5％).原髮于鼻的PE-NHL分期較早,Ⅰ～Ⅱ期佔76.7％.結外瀰漫大B細胞淋巴瘤(PE-DLBCL)患者的3年生存率為73.2％,3年疾病無進展生存率為46.6％.國際預後評估指數(IPI)可以很好地預測PE-DLBCL的預後.多因素分析結果顯示,血沉及首次治療後療效為影響PE-DLBCL患者預後的獨立因素.結論 PENHL的髮病率較高,胃腸道是最常見的受纍器官,最常見的病理類型為瀰漫大B細胞型.按照IPI評分進行危險分層可以反映PE-DLBCL患者的預後,但僅有血沉及首次治療後療效為獨立預後指標.
목적 탐토원발결외비곽기금림파류(PE-NHL)적림상병리특점급예후인소.방법 회고성분석2007년1월지2011년12월진치적151례PE-NHL환자적림상자료.결과 PE-NHL점동기수치비곽기금림파류적58.8％(151/257),평균발병년령위52세,남녀지비위1.16∶1.PE-NHL최상루급적결외기관위위장도(30.5％)、비(19.9％)급Waldeyer배(17.2％),최상견적병리류형위미만대B세포형(55.0％)、NK/T세포형(18.5％)급점막상관결외변연구B세포형(13.2％).림상분기위Ⅰ기31례(20.5％),Ⅱ기45례(29.8％),Ⅲ기44례(29.1％),Ⅳ기31례(20.5％).원발우비적PE-NHL분기교조,Ⅰ～Ⅱ기점76.7％.결외미만대B세포림파류(PE-DLBCL)환자적3년생존솔위73.2％,3년질병무진전생존솔위46.6％.국제예후평고지수(IPI)가이흔호지예측PE-DLBCL적예후.다인소분석결과현시,혈침급수차치료후료효위영향PE-DLBCL환자예후적독립인소.결론 PENHL적발병솔교고,위장도시최상견적수루기관,최상견적병리류형위미만대B세포형.안조IPI평분진행위험분층가이반영PE-DLBCL환자적예후,단부유혈침급수차치료후료효위독립예후지표.
Objective To evaluate the epidermiology,clinicopathological features and prognosis of primary extra-nodal non-Hodgkin's lymphoma (PE-NHL).Methods The clinicopathological data of 151 patients diagnosed as PE-NHL in the First Affiliated Hospital of Jilin University between January 2007 and December 2011 were reviewed and analyzed.Results The proportion of PE-NHL patients was 58.8％ among all the non-Hodgkin's lymphoma cases,with the average age of 52 years,and the male/female ratio was 1.16 ∶ 1.The most frequently involved site was the stomach (30.5％) followed by nose and sinuses (19.9％) and Waldeyer's ring (17.2％).The most common subtype was diffuse large B-cell lymphoma (DLBCL) (55.0％),followed by NK/T (18.5％) and extra-nodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) (13.2％).The distribution of clinical stages was as follows:stage Ⅰ 20.5％,Ⅱ 29.8％,Ⅲ 29.1％,and Ⅳ 20.5％.Most nasal PE-NHL is in early stages,with a proportion of 76.7％ in stages Ⅰ & Ⅱ.The 3-year overall survival rate was 73.2％ and 3-year progression free survival rate was 46.6％ in the PE-DLBCL patients.The International Prognosis Index (IPI) could be used to estimate the prognosis of PE-DLBCL well.Multivariate analysis showed that ESR and curative effect of the first treatment were independent prognostic factors for PE-DLBCL patients.Conclusions The incidence of PE-NHL is quite high,and the most common primary extra-nodal site is the gastro-intestinal tract and the most common subtype is diffuse large B-cell lymphoma.Risk groups based on IPI can indicate the prognosis of PE-DLBCL to some extent,but only the ESR and curative effect of the first treatment are confirmed to be independent risk factors.
