55例NK/T细胞淋巴瘤的病理及临床分析  

An analysis of pathologic diagnosis and clinical therapy on 55 patients with Natural Killer/T cell lymphoma

作　　者：赵妍丽[1] 李秋梅[1] 谭榜宪[1] 张宁玲[1] 李祖茂[2] 

机构地区：[1]川北医学院附院肿瘤科,四川南充637000 [2]川北医学院附院病理科,四川南充637000

出　　处：《中国当代医药》2011年第24期5-7,共3页China Modern Medicine

摘　　要：目的:通过回顾性分析NK/T细胞淋巴瘤的病理特征、临床特点及治疗情况,了解放化疗疗效,为临床诊疗工作提供经验参考。方法:回顾性分析本院55例NK/T细胞淋巴瘤的病理诊断、临床表现等。病检方法为常规镜下活检及免疫组化。治疗方法中以放疗联合化疗为主,少数早期患者采用单纯放疗,部分晚期予以单纯姑息化疗及姑息对症支持治疗。结果:该病临床表现无特异性,以鼻阻、头面部疼痛、难以控制的发热为主。显微镜下多表现为凝固性坏死及混合炎性细胞浸润背景下的密集或散在异型淋巴细胞,可伴有血管浸润。其中36例免疫组化CD5、CD45RO、CD56、Granzyme B的阳性率分别为100.0%、95.4%、80.6%、78.6%。放化疗联合治疗的有效率为70.9%,单纯放疗的有效率为100.0%,姑息化疗的有效率为50.0%。结论:NK/T细胞淋巴瘤的确诊主要依靠病理特点,尤其要将免疫组化结合临床表现综合分析。放化疗等综合治疗效果较佳,早期患者单纯放疗可行,晚期以姑息化疗及支持对症治疗为主。临床上应力争早期诊断,早控症状,个体化治疗,从而提高患者的生活质量,延长生存期。Objective：To provide experiential references for the clinical diagnosis and therapy of Natural Killer/T cell（NK/T） lymphoma via an retrospective analysis of its pathologic and clinical characteristics.Methods：Fifty five cases suffered from NK/T lymphoma were retrospectively analyzed on their pathologic diagnosis,clinical manifestations etc.Pathological examinations were mainly depended on microscopy and immunohistochemisty.Radiotherapy combined with chemotherapy was used in most patients.Simple radiotherapy（prophase）,palliative chemotherapy or supporting therapy（advanced stage） was applied in a few patients.Results：The clinical manifestation of NK/T lymphoma had no specificity.The main symptoms of NK/T lymphoma were nasal obstruction,head and facial pain,and hardly controlled fever.The characteristics of NK/T lymphoma under microscope were mainly shown as intensive or scattered atypical lymphocyte in the field of coagulation necrosis and mixed inflammatory cell infiltration,or sometimes followed by blood vessel infiltration.The positive rate of CD5,CD45RO,CD56,Granzyme B by immunohistochemistry in 36 cases was 100.0%,95.4%,90.6%,78.6%,respectively.The effective powers of radiotherapy combined with chemotherapy,simple radiotherapy and palliation chemotherapy were 70.9%,100.0% and 50.0%,respectively.Conclusion：The final diagnosis of NK/T lymphoma is mainly depended on its pathologic feature,especially,an aggregate analysis about its clinical manifestations and immunohistochemistry results.The highest effective power is using radiotherapy combined with chemotherapy.Simple radiotherapy in prophase patients is feasible,while supported and symptomatic treatments are mainly used in advanced stage patients.Early diagnosis and symptom control,and individuated therapeutic regimen are necessary for improving patient’s quality of life and prolonging their life span.

关 键 词：鼻腔肿瘤 NK/T细胞淋巴瘤 病理诊断 临床诊断 放疗 化疗 

分 类 号：R733[医药卫生—肿瘤]