原发性中枢神经系统淋巴瘤28例临床分析  

Primary central nervous system lymphoma:a report of 28 patients

作　　者：胡毅[1] 冯奉仪[1] 石远凯[1] 周立强[1] 顾大中[1] 王奇璐[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院内科,北京100021

出　　处：《中华肿瘤杂志》2004年第6期375-378,共4页Chinese Journal of Oncology

摘　　要：目的　探讨原发性中枢神经系统淋巴瘤 (PCNSL)的合理治疗方式及影响预后的因素。方法　回顾性分析 2 8例PCNSL的临床特征、治疗结果及预后因素 ,运用SPSS 10 .0软件包进行统计分析。结果　 2 8例PCNSL患者中 ,男性 18例 ,女性 10例 ,中位年龄 5 2岁。全组中位生存期 (MST) 2年 ,5年生存率 2 1.4 % ;单病灶 19例 ,多病灶 9例。病理检查为B细胞来源者占 78.6 % (2 2 / 2 8) ,病理类型以弥漫性大细胞淋巴瘤为主。依国际工作分类 (WF) ,中度恶性占 5 7.7% (15 / 2 8)。多因素分析结果显示 ,病灶的单发或多发是影响预后的独立因素 (P =0 .0 4 17)。对B细胞来源、WF高度恶性及多病灶的PCNSL患者 ,合并化疗的综合治疗效果较好 ,其中合并非常规化疗的疗效优于常规化疗疗效(P =0 .0 191)。结论　PCNSL较一般的NHL具有独特的预后因素 ;化疗在PCNSL的综合治疗中极为重要 。Objective To evaluate the clinical characteristics, reasonable mode of treatment and prognostic factors in patients with primary central nervous system lymphoma (PCNSL). Methods Twenty eight patients with PCNSL treated from 1989 to 2002 were retrospectively reviewed. The clinical characteristics, results of treatment and prognostic factors were analyzed by SPSS10.0 statistic software. Results Of 28 patients, 18 men and 10 women with a median age of 52 years. The median survival time was 2 years (range 6 months 6 years). The 5 year survival rate was 21.4%. Nineteen patients had single locus lesion and 9 multi locus lesion, 78.6% of the patients were diagnosed as having B cell origin, its main type being diffuse large cell lymphoma. According to international working formulation (WF), moderate grade of histopathology was observed in 57.7% (15/28). Cox regression analysis revealed that single or multi locus lesion was only independent prognostic factor ( P = 0.0417 ). Combined chemotherapy showed significant efficacy for those patients who had lesion of B cell origin, high grade or multi locus lesion, and the efficacy of irregular chemotherapy was better than that of regular chemotherapy. Conclusion Primary central nervous system lymphoma has a special prognostic factor. Chemotherapy plays a very important role in comprehensive treatment, irregular chemotherapy should be adopted as a regular treatment.

关 键 词：原发性中枢神经系统淋巴瘤 PCNSL 非霍奇金 治疗方式 肿瘤 

分 类 号：R739.4[医药卫生—肿瘤]