29例原发系统性间变大细胞淋巴瘤的病理特点及临床分析  

The clinical and pathological analysis for 29 cases with systemic anaplastic large cell lymphoma

作　　者：陈焱[1] 何群[1] 舒义刚[1] 李晓林[1] 

机构地区：[1]中南大学湘雅医院血液科,长沙410008

出　　处：《临床血液学杂志》2009年第2期132-134,共3页Journal of Clinical Hematology

摘　　要：目的:探讨原发系统性间变大细胞淋巴瘤(ALCL)的病理特点、临床特征与预后的关系。方法:对29例原发系统性ALCL患者的病理特点、临床特征、完全缓解率(CR)、长期生存率和预后因素进行了分析。结果:所有病例的瘤细胞均强表达CD30,58.62%间变性淋巴瘤激酶(ALK)阳性。接受了治疗的28例患者的CR率为50.0%,2年和5年生存率分别为51.3%与27.1%。ALK阳性患者CR为68.8%,2、5年无病生存率分别为60.2%、42.5%,明显高于ALK阴性组(P<0.05)。国际预后指数(IPI)0～2分患者组CR率为57.1%,2年、5年无病生存率分别为80.2%、65.1%,明显高于IPI3～5分患者组(P<0.05)。Cox比例风险回归分析表明ALK的表达、IPI评分对预后的影响有统计学意义(P<0.05)。结论:ALK表达、IPI评分有助于判断原发系统性ALCL的预后,并为个体化治疗提供了依据。Objective：To study the correlation of clinical prognosis with pathological and clinical features in patients with systemic anaplastic large cell lymphoma （ALCL）. Method： Twenty-nine patients diagnosed with systemic ALCL were analyzed by the clinical and pathological features, complete remission （CR）, long-term survival rate, and prognostic factors. Result：All patients were CD30 positive. Positive rate of anaplastic lymphoma kinase （ALK） was 58.62%. The CR of 28 patients was 50.0%, and overall survival （OS） rate at 2-year and 5-year were 51.3% and 27.1%, respectively. The CR of ALK positive patients was 68.8%, and 2-year and 5-year OS rate were 60.2 % and 42.50% respectively, which were remarkable higher than ALK negative patients （P〈0.05）. The CR of patients with international prognostic index （IPI） in 0-2 was 57.1%, and 2-year and five-year OS rate were 80.2% and 65.1% respectively, which were remarkable higher than patients with IPI in 3~5 （P^0.05）. In addition, multivariate analysis confirmed the progaostic value of ALK protein expression and IPI （P〈0.05）. Conclusion..The expression ALK protein and IPI can be served as independent prognostic predictors or clinical outcome and can be guiding of individualized treatment in patient with systemic ALCL.

关 键 词：淋巴瘤 间变大细胞 国际预后指数 间变性淋巴瘤激酶 

分 类 号：R733.4[医药卫生—肿瘤]