47例结外NK/T细胞淋巴瘤治疗和预后分析  

Therapy and Prognosis Analysis of 47 Patients with Extranodal NK/T-Cell Lymphoma

作　　者：张松松[1] 魏敏[1] 李红华[1] 靖彧[1] 李菲[1] 黄文荣[1] 陆晓林[1] 刘占祥[1] 周颖[1] 于力[1] 

机构地区：[1]中国人民解放军总医院血液科,北京100853

出　　处：《中国实验血液学杂志》2011年第1期119-123,共5页Journal of Experimental Hematology

摘　　要：本研究探讨结外NK/T细胞淋巴瘤的临床特征、治疗和预后情况。对中国人民解放军总医院血液科自1995年10月到2008年12月收治的47例结外NK/T细胞淋巴瘤患者进行回顾性分析。运用Kaplan-Meier方法行生存分析,COX回归分析模型对预后进行多变量分析。采用的临床参数分别为CD56、Ann Arbor分期、国际预后指标和B组症状。结果表明,全组2年、5年总生存(OS)率分别为91%和71%。单纯放疗患者的累积生存率较单纯化疗患者明显提高,二者相比有统计学差异;而放疗与放化疗结合治疗之间无统计学差异。COX回归分析模型多变量分析显示,CD56、Ann Arbor分期是独立的预后因素;单纯化疗中使用CHOP方案治疗的患者以分期为单因素分析显示,分期≥ⅢE期为预后的因素之一;以B症状为单因素分析3种疗法的生存曲线显示,B症状亦为预后因素之一。结论:单纯放疗的近期疗效明显优于单纯化疗,放化疗结合对近期生存率没有显著提高;CD56阴性和Ann Arbor分期较早是患者预后良好的指标,改善病人的一般状况可以使患者的预后更佳。This study was purposed to explore the clinical characteristics,therapy and prognosis of patients with extranodal NK/T cell lymphoma（ENKL）.47 patients with ENKL from October 1995 to December 2008 in our hospital were analyzed retrospectively.The survival of patients was analyzed by using Kaplan-Meier methods,the prognosis of patients was evaluated by multivariate analysis using COX regression model.The clinical parameters used included CD56,Ann Arbor stage,international prognostic index（IPI） and B symptom.The results showed that the 2-year and 5-year overall survival（OS） rates were 91%,71% respectively.Multivariant analysis by COX regression showed the CD56 and Ann Arbor stage were independent prognostic factors.Single factor analysis with staging in CHOP chemotherapy group indicated that more than stage ⅢE（including ⅢE） was a prognostic factor.Single factor analysis with B symptom showed that B symptom also was a prognostic factor.The cumulative survival rate of patients received radiotherapy alone was higher than that of patients got chemotherapy alone,its difference had a statistical significance,but there was no statistical significance between radiotherapy group and chemoradiotherapy group.It is concluded that CD56,Ann Arbor stage and B symptoms are prognostic factors.Radiotherapy alone is better than chemotherapy alone in therapy of ENKL.Chemotherapy combined with radiotherapy can not improve the survival.Improving the status of patients can make prognosis better.

关 键 词：结外NK/T细胞淋巴瘤 淋巴瘤放疗 淋巴瘤化疗 淋巴瘤预后因素 

分 类 号：R733.1[医药卫生—肿瘤]