睾丸恶性淋巴瘤26例临床分析  

Clinical analysis of 26 patients with testicular lymphoma

作　　者：陈蕾[1] 王中华[1] 胡夕春[1] 王佳蕾[1] 洪小南[1] 李小秋[2] 叶定伟[3] 

机构地区：[1]复旦大学附属肿瘤医院肿瘤内科,上海200032 [2]复旦大学附属肿瘤医院病理科,上海200032 [3]复旦大学附属肿瘤医院泌尿外科,上海200032

出　　处：《肿瘤》2008年第11期976-979,共4页Tumor

摘　　要：目的:睾丸恶性淋巴瘤临床较为少见,本文总结了该病的临床特点、诊断、治疗方法及其预后。方法:26例睾丸恶性淋巴瘤,原发22例(84.6%),继发4例(15.4%),所有患者均接受睾丸手术切除治疗,病理诊断明确。原发睾丸恶性淋巴瘤患者中可随访的为19例,其中3例仅接受手术治疗,14例接受了手术和化疗,2例患者接受了手术联合化疗和放疗。4例继发患者均接受了局部放疗和全身化疗。结果:全组原发患者的中位年龄57岁,首发症状均为无痛性睾丸肿大,主要病理类型为弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL),占84.6%(22/26),少见病理类型包括NK/T细胞淋巴瘤、淋巴母细胞淋巴瘤和B细胞不能分型者。所有原发患者的5年生存率为72%,Ann-Arbor分期Ⅰ～Ⅱ期患者的中位生存时间(median survival time,MST)为95.8个月,Ⅲ～Ⅳ期的MST时间为21.5个月。接受手术和化疗的患者的中位复发和MST分别为78.8和92.3个月。继发患者的中位复发时间为7.5个月,MST为25.0个月。结论:睾丸恶性淋巴瘤好发于老年男性,其预后可能与临床分期、病理类型和治疗方法有关。建议对所有患者在手术后进行放疗,并给予4～6个疗程的CHOP/CHOP-like方案化疗。Objective： Malignant testicular lymphoma was rare in clinic. This study is to summarize the clinical features, diagnosis, treatment, and prognosis of testicular lymphoma. Methods： Twenty-six malignant testicular lymphoma patients were treated during the period between 1980 and 2007. The patients included 22 cases of primary testicular lymphoma （84.6%） and 4 cases of secondary testicular lymphoma （ 15.4% ） confirmed by histopathological examination. All the patients received testectomy. Nineteen patients with primary testicular lymphoma were followed up. Out of the 19 cases, 3 cases received surgery only, 14 cases received chemotherapy and surgery, and 2 cases received surgery combined with radiotherapy and chemotherapy. All of the primary primary 4 cases with secondary testicular lymphoma received whole body chemotherapy and local radiotherapy. Results： All of the primary patients, with a median age of 57 years, initially presented a painless testicular enlargement. The most common pathological type was diffuse large B-cell lymphoma （DLBCL） （84.6%, 22/26）. Less common types included extranodal NK/T cell lymphoma, lymphoblastic lymphoma, and unclassifiable B-cell lymphoma. The 5-year overall survival rate of primary testicular lymphoma patients was 72%. The median survival time of the patients was 95.8 months for those at Ⅰ / Ⅱ Ann-Arbor staging and 21.5 months for those at Ⅲ/Ⅳ Ann-Arbor staging, respectively. The median survival time without relapse was 78.8 months and the median survival time was 92.3 months for the patients who were treated with combined surgery and chemotherapy. The median survival time without relapse was 7.5 months and overall survival time was 25 months for the patients with the secondary testicular lymphoma. Conclusion： Testicular lymphomas predominantly occurred in elderly males. The prognosis may be related with clinical staging, pathological classification, and therapeutic regimens. The work recommended adjuvant radiotherapy and four to six cycles of CHOP

关 键 词：睾丸肿瘤 淋巴瘤 预后 临床方案 

分 类 号：R733.1[医药卫生—肿瘤] R737.21[医药卫生—临床医学]