原发性卵巢非霍奇金淋巴瘤32例临床分析  

Clinical analysis of 32 patients with ovarian non-Hodgkin’slymphoma

作　　者：吴建磊[1] 接智慧[1] 史春雪[2] 常爽[1] 王敏[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004 [2]沈阳市妇婴医院妇科,辽宁沈阳110014

出　　处：《中国实用妇科与产科杂志》2013年第5期359-363,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金项目(30973189)

摘　　要：目的探讨原发性卵巢非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)的诊断、治疗方法及预后。方法回顾性分析中国医科大学附属盛京医院1995年1月至2012年1月共32例原发性卵巢NHL的手术、化疗、放疗等相关完整的临床资料。结果 32例患者临床表现:腹痛22例,腹部包块19例,腹胀10例,月经减少6例,4例腹水,3例阴道出血;5例合并邻近或远处淋巴结浸润或器官浸润,其中腹膜后淋巴结4例,左锁骨上淋巴结1例,肠管1例,全身多部位2例。术后病理诊断:29例NHL,B细胞来源;1例为Burkitt淋巴瘤;1例为间变性大细胞淋巴瘤,T细胞来源;1例为双侧卵巢NHL未分类,T细胞来源。23例获随访,有16例术后接受化疗,2例术后接受放疗,5例患者术后未经放化疗。4例仍存活,19例死亡,最长存活95个月,最短1.5个月,中位总生存时间为24.5个月(1.5～95个月);总的1年、5年生存率分别为82.6%(19/23)和34.8%(8/23),手术切除卵巢原发灶加上化疗和(或)放疗可取得良好效果。结论原发性卵巢NHL临床上容易误诊,认识其临床特征,尽早采取综合治疗,可以延长患者的生存期。Objective To explore the diagnosis,treatment and prognosis of the ovarian non-Hodgkin＇s lymphoma（NHL）. Methods Between January 1995 and January 2012,32 patients with ovarian NHL had received therapy as surgery, chemotherapy and radiotherapy. Results Clinical manifestation of 32 patients. 22 patients of abdominal pain, abdomen enclosed mass （ 19 cases） , 10 cases of abdominal distension, menstruation reduce in 6 patients, 4 cases of ascites, 3 cases vaginal bleeding. 5 cases with neighboring or distant lymph node invasion or organ infiltrates, one retroperitoneal lymph node 4 cases, left supraclavicular lymph nodes in 1, 1 case with bowel, whole body multiple places in 2 cases. Postoperative pathologic diagnosis, 29 cases of NHL, B cells sources ; 1 case of Burkitt lymphoma ; 1 case of large cell lymphoma between degeneration, T cells sources ; 1 case of bilateral ovarian NHL not classification, T ceils sources. 23 patients had been followed up till death; there are 16 cases of postoperative chemotherapy and 2 patients received radiotherapy, 5 patients without postoperative radiation and chemotherapy. 4 cases still live, and 19 deaths. The median survival time was 24. 5 months（range 1.5 months to 95 months） ; the overall 1 year and 5 year survival rates are 82. 6% （ 19/23 ） and 34. 8% （ 8/ 23 ） , respectively; surgical resection primary focus plus chemotherapy or radiotherapy will achieve good effects. Conclusion It is easy to misdiagnose for the primary ovarian NHL in clinic, awareness of their clinical features as soon possible to adopt a muhimodality therapy, which prolong survival time of patients.

关 键 词：卵巢 非霍奇金淋巴瘤 综合治疗 

分 类 号：R711.75[医药卫生—妇产科学]