35例原发性肝脏淋巴瘤的临床病理特点及预后分析  

Clinicopathological and survival features of primary hepatic lymphoma： an analysis of 35 cases

作　　者：赵骞[1] 刘海平[1] 顾怡瑾[1] 丛文铭[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院病理科,上海200438

出　　处：《中华肿瘤杂志》2013年第9期689-692,共4页Chinese Journal of Oncology

摘　　要：目的探讨原发性肝脏淋巴瘤（PHL）的临床病理学特点及预后。方法回顾性分析1982年1月至2012年12月经手术切除并经术后病理证实的35例PHL患者的临床和随访资料，对其临床表现、影像学特点、免疫组化分型以及预后进行分析。结果35例PHL患者中，男25例（71．4％），女10例（28．6％）；平均年龄52．6岁。主要症状为发热、右上腹疼痛和肝占位等。血清乙肝表面抗原阳性21例，血清抗丙肝病毒抗体阳性1例，血清甲胎蛋白水平升高3例，血清CAl99水平升高2例，伴有肝硬化12例，伴有肝癌2例。病理分型为弥漫性大B细胞淋巴瘤（DLBCL）19例（54．3％），T细胞PHI。13例（37．1％），结外黏膜相关组织边缘区淋巴瘤3例（8．6％）。32例患者行手术切除加术后辅助治疗。DI．BCL患者的术后生存时间为（31．7±3．2）个月，明显长于T细胞PHL患者[（22．9±2．2）个月，P〈0．05]。结论PHL的发生可能与乙型肝炎病毒的感染有关，手术切除加辅助治疗是PHL的主要治疗模式，PHI．的预后与病理分型有关。Objective To evaluate the clinieopathological features and prognosis of primary hepatic lymphoma （PHL）. Methods Thirty-five patients with PHL who underwent surgical resection and were confirmed by pathology in our hospital from 1982 to 2012 were re-evaluated for elinieopathologieal data, including their symptoms, radiologieal features, recurrence interval, histopathological properties and prognosis. Results Of the 35 patients, 25 were men （71.4%） and 10 were women （28.6%）, with an average age of 52.6 years old （range, 17-79 years）. Presented symptoms were epigastrie phymatosis, abdominal pain and low-grade fever. In the present study, 21 （60.0%） patients were positive for HBsAg, 1 （2.9%） patient was positive for anti-HCV, 3 patients were positive for AFP, 12 patients and 2 patients were complicated by cirrhosis and hepatoeellular carcinoma, respectively. Pathologically, 35 PHL were elassified into 19 DLBCL （54.3%）, 13 T eell-lymphoma （37.1%）, and 3 MALT lymphoma （8.6%）. Patients with DCBCL showed better postoperative survival than patients with T eell-lymphoma （ 31.7 ＋ 3.2） months vs. （22.9 ＋ 2.2 ） months （ P 〈 0.05 ）. Conclusions Hepatitis B vivus （HBV） infection may contribute to the pathogenesis of Chinese patients with PHL. Surgical resection followed by comprehensive therapy is the first-line option for PHL. The prognosis of patients with PHL is associated with PHL subtypes.

关 键 词：肝肿瘤 淋巴瘤 病理学 诊断 预后 

分 类 号：R735.7[医药卫生—肿瘤]