脾脏原发性恶性淋巴瘤29例临床分析  

Primary splenic lymphoma： clinical analysis of 29 cases

作　　者：张慧明[1] 崔修铮[1] 李智宇[1] 王一澎[1] 

机构地区：[1]中国医学科学院肿瘤医院腹部外科,北京100021

出　　处：《中华普通外科杂志》2009年第5期356-358,共3页Chinese Journal of General Surgery

摘　　要：目的分析原发性脾脏恶性淋巴瘤的临床特征。方法回顾性分析2000年11月至2008年8月收治的29例脾脏原发性恶性淋巴瘤患者的临床资料。结果29例患者中，非霍奇金淋巴瘤27例，霍奇金淋巴瘤2例。根据Ahmann脾淋巴瘤临床分期，Ⅰ期6例，Ⅱ期4例，Ⅲ期19例。26例患者进行了脾脏切除术，2例因病变侵犯胰尾而行脾脏切除＋胰体尾切除术，1例因侵犯胃行脾脏切除＋部分胃切除术。术后19例患者接受了辅助性化学治疗，5例使用利妥昔单抗（美罗华）。1例患者接受了区域淋巴结放射治疗。中位随访时间24个月（2～93个月），脾脏原发性恶性淋巴瘤1、3和5年的总生存率分别为：96％、83％和73％，1、3和5年的无瘤生存率分别为96％、51％和51％。结论脾脏原发性恶性淋巴瘤是最常见的原发性脾脏恶性肿瘤，手术切除脾脏及其周围受累器官是重要的治疗方法，手术后应当辅以化疗、放疗、生物治疗等措施。Objective To analyze the clinical features of primary splenic lymphoma. Method Clinicopathologic features of 29 patients with primary splenic lymphoma treated in Cancer Hospital, Chinese Academy of Medical Sciences from November 2000 to August 2008 were analyzed retrospectively. Results In this study 27 cases were confirmed to be non-Hodgkin＇s lymphoma （ NHL）, and 2 cases were of Hodgkin＇s lymphoma （HL）. According to Ahmann＇s staging, 6 eases belonged to stage Ⅰ, 4 was stage Ⅱ, and 19 was stage Ⅲ. Twenty-six patients received splenectomy, 2 cases did splenectomy plus pancreatic body and tail resection, and 1 case did splenectomy plus partial gastrectomy. Postoperatively, 19 cases received chemotherapy, and 5 of the 19 patients received rituximab （Mabthera） treatment. One patient received radiotherapy for regional lymph node invasion. The median time of fallow-up was 24 months （range, 2 -93 months）. The 1-year, 3-year and 5-year overall survival rates were 96% , 83% and 73%, respectively. The 1-year, 3-year and 5-year disease-free survival rates were 96% , 51% and 51%, respectively. Conclusions Primary splenic lymphoma is the most common malignant tumor of the spleen. Spleneetomy combined with excision of invaded tissues or organs is important therapy for patients with primary splenic lymphoma. Comprehensive treatments including chemotherapy, radiotherapy and biotherapy are recommended after operation.

关 键 词：脾脏 淋巴瘤 外科手术 临床特征 

分 类 号：R686[医药卫生—骨科学]