20例乳腺原发性恶性淋巴瘤临床病理及预后分析  

The Clinico-pathological Features and Prognosis of Primary Malignant Lymphoma of Breast

作　　者：朱元喜[1] 孙保存[2] 马淑资[1] 方志沂[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺科,天津市300060 [2]天津医科大学附属肿瘤医院病理科,天津市300060

出　　处：《中国肿瘤临床》2001年第7期504-507,共4页Chinese Journal of Clinical Oncology

摘　　要：目的：探讨乳腺原发性恶性淋巴瘤（PBL）的临床病理特征、治疗方式及其与预后的关系。方法：对1982～1999年间收治的经病理组织学证实为PBL 20例患者进行随访分析，并给予化疗，肿块切除＋化疗，肿块切除＋化疗＋放疗，乳房切除或根治术＋化疗，乳房切除或根治术＋化疗＋放疗等不同治疗方式。结果：本组PBL均为女性，中位年龄39岁，占同期乳腺恶性肿瘤的0．18％，均为B细胞来源，绝大多数为中度恶性，低度和高度恶性较少。PBL 1、3、5年总生存率分别为68．75％、31．25％、12．50％；Ⅰ＋Ⅱ期PBL 1、3、5年生存率分别为100．00％、33．33％、22．22％；Ⅳ期分别为28．57％、28．57％、0；Ⅰ＋Ⅱ期PBL不同治疗方式1、3、5年生存情况：肿块切除＋化疗和（或）放疗：4／4，2／4，1／4；乳房切除或根治术＋化疗和（或）放疗：5／5，2／5，1／5。结论：PBL预后较差，与其病理类型、临床分期及治疗方式有关，乳房切除或根治术对PBL预后无意义，甚至可能有害无益，化疗及放疗对其预后有利，尤其是巩固化疗对改善PBL预后非常有益。Objective To study the clinico－pathological features treatment modality and prognostic factors of primary lymphoma PBL． Methods Twenty pathologically confirmed PBL patients hospitalized in the period of 1982 to 1999 were treated by chemotherapy tumor resection plus chemotherapy tumor resection plus chemotherapy plus radiotherapy mastectomy or radical excision plus chemotherapy mastectomy or radical excision plus chemotherapy plus radiation etc． Results All patients were female with a median age of 39yr． It constituted 0．18％ of all maligant breast tumors and all were originated from B cell lineage． Intermediate grade was predominant in classification and overall 1－3－5－year survival rates were 68．75％ 31．25％ 12．50％ respectively． The 1－ 3－ 5－year survival rates in stage Ⅰ plus stage Ⅱ were 100．00％ 33．33％ 22．22％ respectively while in stage Ⅳ were 28．57％ 28．57％ 0％ respectively． For stage Ⅰ plus stage Ⅱ PBL the 1－3－5－year survival status of the patients treated by tumor resection plus chemotherapy and／or radiation were 4／4 2／41／4 respectively while those of mastectomy or radical excision plus chemotherapy and／or radiation were 5／5 2／5 1／5 respectively． Conclusion The prognosis of PBL is poor it is associated with the clinical stage pathological type and treatment modalities． Mastectomy or radical excision does not appear effect on PBL． Chemotherapy or radiotherapy is beneficial to prognosis particularly consolidatory chemotherapy is helpful for the prognosis of PBL．

关 键 词：乳腺肿瘤 淋巴瘤 临床病理特征 治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]