CAJ | 학술논문

目的：探讨原发乳腺弥漫大B细胞淋巴瘤（DLBCL）患者的临床特征、治疗及预后。方法回顾性分析21例原发乳腺DLBCL患者的临床资料，用Kaplan-Meier法分析5年总生存（OS）率，采用Log-rank检验法进行亚组间差异性分析。结果21例患者均为女性，中位年龄48（21~64）岁，其中国际预后指数（IPI）评分0分者13例，1分者6例，2分者2例。21例患者中R-CHOP/CHOP方案治疗组（6例）和EPOCH±R序贯DICE±R方案治疗组（15例）患者的5年OS率分别为40.0%和72.2%，差异有统计学意义（P=0.035）；中枢神经系统复发率分别为16.7%和6.7%（P=0.500）；ⅡE~ⅢE期组（9例）和ⅠE期（12例）患者5年OS率分别为21.4%和83.3%，差异有统计学意义（P=0.025）。结论原发乳腺DLBCL临床少见，EPOCH±R序贯DICE±R方案治疗可改善患者预后，降低中枢神经系统复发率；ⅡE~ⅢE期者较ⅠE期者预后更差。
목적：탐토원발유선미만대B세포림파류（DLBCL）환자적림상특정、치료급예후。방법회고성분석21례원발유선DLBCL환자적림상자료，용Kaplan-Meier법분석5년총생존（OS）솔，채용Log-rank검험법진행아조간차이성분석。결과21례환자균위녀성，중위년령48（21~64）세，기중국제예후지수（IPI）평분0분자13례，1분자6례，2분자2례。21례환자중R-CHOP/CHOP방안치료조（6례）화EPOCH±R서관DICE±R방안치료조（15례）환자적5년OS솔분별위40.0%화72.2%，차이유통계학의의（P=0.035）；중추신경계통복발솔분별위16.7%화6.7%（P=0.500）；ⅡE~ⅢE기조（9례）화ⅠE기（12례）환자5년OS솔분별위21.4%화83.3%，차이유통계학의의（P=0.025）。결론원발유선DLBCL림상소견，EPOCH±R서관DICE±R방안치료가개선환자예후，강저중추신경계통복발솔；ⅡE~ⅢE기자교ⅠE기자예후경차。
Objective To evaluateclinical features, treatment and outcomes of patients diagnosed with primary breast diffuse large B-cell lymphoma(DLBCL). Methods Clinical data were analyzed for all patients diagnosed with primary breast DLBCL(n=21). Kaplan-Meier method was used to estimate 5-year overall survival(OS)rate, and the difference was compared by Log-rank test. Results The 21 cases of patients with primary breast DLBCL were all female with median age at diagnosis as 48 years (range 21-64 years). 13 patients had International Prognostic Index(IPI)of 0, 6 IPI 1, and 2 IPI 2. The 5-year OS rates of CHOP/R-CHOP and R ± DICE after R ± EPOCH groups were 40.0% and 72.2%, respectively(P=0.035). The central nervous system relapse rate of CHOP/R-CHOP and R±DICE after R± EPOCH groups were 16.7% and 6.7%(P=0.500), respectively. The 5-year OS rates of patients with primary breast DLBCL staging ⅡE-ⅢE and ⅠE were 21.4% and 83.3%, respectively (P=0.025). Conclusions Primary breast DLBCL was rare. The patients of primary breast DLBCL with chemotherapy regimen of R ± DICE after R ± EPOCH might have a better prognosis and lower relapse rate of central nervous system;the primary breast DLBCL patients stagingⅡE-ⅢE might have a poor prognosis.