CAJ | 학술논문

目的探讨结节性淋巴细胞为主型霍奇金淋巴瘤(NLPHL)患者的临床病理特征及疗效.方法收集14例NLPHL患者的临床资料,对其临床病理特征及近、远期疗效进行相关性分析.结果 14例患者均为初治者,男、女各7例,中位发病年龄38(13～ 54)岁,中位随访时间为55.5(23～189)个月.发病率占同期霍奇金淋巴瘤(HL)的6.3％(14/223).免疫组织化学检查结果示14例患者CD20均呈(+)/弱(+),CD30均(-),仅1例患者呈CD15弱(+).14例患者中13例因自觉浅表淋巴结肿大就诊,所有患者惰性起病,病情进展缓慢.7例患者采用单纯化疗,7例患者采用放、化疗联合治疗.14例患者均有效,其中完全缓解(CR)+未证实的CR(CRu) 12例.5年无疾病生存率为85.7％,5年总生存率为100.0％.单纯化疗与放、化疗联合治疗相比,不同的化疗方案相比,其近、远期疗效差异均无统计学意义(P值均＞0.05).结论 NLPHL患者瘤细胞呈CD20(+)/弱(+),CD30(-),极少数患者呈CD15弱(+).NLPHL在HL患者中所占比例低,以中青年患者多见,起病缓慢,与经典型HL患者相比疗效较好.
목적 탐토결절성림파세포위주형곽기금림파류(NLPHL)환자적림상병리특정급료효.방법 수집14례NLPHL환자적림상자료,대기림상병리특정급근、원기료효진행상관성분석.결과 14례환자균위초치자,남、녀각7례,중위발병년령38(13～ 54)세,중위수방시간위55.5(23～189)개월.발병솔점동기곽기금림파류(HL)적6.3％(14/223).면역조직화학검사결과시14례환자CD20균정(+)/약(+),CD30균(-),부1례환자정CD15약(+).14례환자중13례인자각천표림파결종대취진,소유환자타성기병,병정진전완만.7례환자채용단순화료,7례환자채용방、화료연합치료.14례환자균유효,기중완전완해(CR)+미증실적CR(CRu) 12례.5년무질병생존솔위85.7％,5년총생존솔위100.0％.단순화료여방、화료연합치료상비,불동적화료방안상비,기근、원기료효차이균무통계학의의(P치균＞0.05).결론 NLPHL환자류세포정CD20(+)/약(+),CD30(-),겁소수환자정CD15약(+).NLPHL재HL환자중소점비례저,이중청년환자다견,기병완만,여경전형HL환자상비료효교호.
Objective To probe the clinical and pathological characteristics of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL).Method The pathologically confirmed 14 cases of NLPHL patients (since January 2001 to December 2012) were collected from Tianjin Medical University Cancer Hospital.The laboratory examinations' results,clinical manifestations,short-term and long-term outcomes of these cases were analyzed in this study.Results The immunohistochemistry of all cases showed CD20 (+)/weak (+) and CD30 (-),most of them CD 15 (-).The morbidity of NLPHL during the same period of Hodgkin' s lymphoma (HL) was around 6.3％.The median age was 38 (13-54) years old,92.9％ of the patients sought medical advice according to self-feeling of superficial lymph nodes.All patients' disease progressed slowly and the sizes of lymph nodes were within 3 cm.Of the 14 patients,7 patients were treated with chemotherapy and 7 patients chemoradiotherapy.The treatment results showed CR+CRu rate as 85.7％ and ORR 100.0％.The rates of 5-year event-free survival (EFS) and overall survival (OS) were 85.7％ and 100.0％ respectively.Short and long term efficacies between chemotherapy and chemoradiotherapy had no significant differences.Meanwhile,varieties chemotherapy regimens showed no significant effects on short-and long-term efficacies (P＞0.05).Conclusions The pathologically confirmed 14 cases of NLPHL had the classical and tumorous maxi cell,which showed CD20 (+)/weak(+) and CD30 (-),very few cases showed weak CD 15 (+).The incidence of NLPHL was low.The majority of the NLPHL patients were middle-aged and youth.Moreover,the better short-and long-term outcomes over classical HL ones were observed regardless of patients' stage.