女性生殖系统原发性恶性淋巴瘤9例临床分析  

Clinical analysis of nine cases of primary malignant lymphoma in female genital system

作　　者：周凤智[1] 张国楠[1] 孙维刚[2] 宋水勤[1] 樊英[1] 

机构地区：[1]成都四川省肿瘤医院妇瘤科,610041 [2]成都四川省肿瘤医院病理科,610041

出　　处：《中国妇产科临床杂志》2005年第6期409-412,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨女性生殖系统原发性恶性淋巴瘤的临床特征、治疗方法以及影响预后的因素.方法回顾性研究9例患者的临床病理资料,分析其临床分期、病理类型、治疗方法与其预后的关系.结果发病部位以卵巢居多(4例),其次是宫颈3例、宫体和阴道各1例.临床表现:病变累及子宫和阴道者以阴道不规则流血、分泌物增多为主要症状(5/5);而病变在卵巢者则表现为腹部包块和腹痛,以双侧多见.FIGO分期ⅢB期3例、Ⅲc期2例、Ⅳ期1例;ⅠB期3例.B细胞来源6例,为低-中度恶性,T细胞来源2例均为高度恶性,1例来源不明.治疗多采用手术、化疗为主的综合治疗.9例患者现存活4例,其中ⅠB期3例,ⅢB期1例,均为B细胞来源.1例已生存8年,1例已生存5年,5例在1～2年内恶化或死亡,2例治疗后不到2年仍在随访中.结论卵巢恶性淋巴瘤较生殖系统其他部位淋巴瘤预后差.化疗联合手术及放疗的综合治疗能明显改善患者的预后.对伴有较大宫颈、阴道肿瘤的患者应及早放疗.临床分期、病理类型和治疗方法是影响预后的因素.Objective To investigate the clinical characteristics, outcome of treatment, and prognostic factors of primary malignant lymphoma in female genital system. Methods Retrospective analysis was conducted on the clinicopathological characteristics of nine women with primary malignant lymphoma in female genital system, and on the relationship between clinical staging, histological types, treatment and prognosis. Results The tumor mainly involved ovary （4 cases）, cervix （3 cases）, the vagina and the endometrium （1 case）. The patients with cervix, uterus and vagina involvement usually presented abnormal vaginal bleeding, discharge （5/5）. The tumor originated in the ovary was found with palpable mass, abdomen pain and usually involved bilateral ovaries. According to FIGO staging, 6 cases were stage Ⅲ-Ⅳ （66.8%）, 3 stage ⅢB, 2 stage Ⅲc, 1 stage Ⅳ and 3 cases were stage ⅠB. Six patients were diagnosed with B-cell subtype, low-mid grade, 2 T-cell and high grade malignancy, 1 indefinitive lesions. Most patients underwent surgery and chemotherapy. Up to date 4 patients with T-cell lymphoma were surviving, among which 3 were in stage Ⅰ B and 1 stage ⅢB. One patient has survived for 8 years, 1 for 5 years. Two women were followed up for less than 2 years and 5 cases developed or died within 1-2 years after diagnosis. Conclusions The prognosis of ovarian lymphoma is worse than that of other genital sites. Comprehensive treatment with chemotherapy surgery and radiotherapy can remarkably improve the outcome. Radiotherapy should be timely given for bulk cervical and vaginal lymphoma. Clinical stage, histological type and treatment are prognostic factors.

关 键 词：淋巴瘤 生殖系统肿瘤 女性 治疗 预后 

分 类 号：R737.3[医药卫生—肿瘤]