原发结外淋巴瘤的临床特点及疗效观察  

Clinical characteristics and curative effect observation of primary extranodal lymphoma

作　　者：王桂梅 王宝宏[2] 王艳艳 杨婷婷[1] WANG Guimei;WANG Baohong;WANG Yanyan;YANG Tingting(Department of Internal Medicine,Weifang Medical University,Weifang 261053,China;Department of Hematology,Weifang People's Hospital)

机构地区：[1]潍坊医学院内科学教研室,山东潍坊261053 [2]潍坊市人民医院血液科

出　　处：《潍坊医学院学报》2018年第6期414-416,共3页Acta Academiae Medicinae Weifang

摘　　要：目的分析原发结外淋巴瘤(PENL)临床特征,观察其应用以CHOP或R-CHOP为主的治疗方案的疗效。方法回顾性分析2015年1月～2017年1月就诊于潍坊市人民医院经病理和免疫组织化学确诊的89例原发结外淋巴瘤患者,对其在年龄、性别、首发部位、病理分型等方面进行总结分析。选择符合纳入标准的76例结外淋巴瘤患者,观察其总缓解率(ORR)、总生存期(OS)及无进展生存时间(PFS)。结果 (1)临床特点:89例结外淋巴瘤患者中,中位年龄55(14～89)岁;男女比例为1. 2∶1;首发部位常见于胃肠道、鼻、扁桃体、乳腺、皮肤等部位;病理类型以弥漫大B细胞淋巴瘤(DLBCL)为主,占58. 4%.不同性别与各病理类型间没有统计学意义(P=0. 638),不同年龄段与各病理类型间没有统计学意义(P=0. 125)。(2)符合收纳标准的76例结外淋巴瘤患者,中位无进展生存期16(0～36)个月,中位总生存期为27(2～40)个月,总有效率88%.结论结外淋巴瘤临床表现多样,症状及体征不典型,容易出现漏诊、误诊,当出现原发器官的肿大或局部肿块形成时应注意及时行病理检查明确诊断。应根据临床表现及病理分型制定个体化治疗方案,经典化疗方案CHOP或R-CHOP有较好的疗效。Objective To analyze the clinical features of primary extranodal lymphoma( PENL) and to observe the therapeutic effect of CHOP or R-CHOP based treatment. Methods Eighty-nine cases of primary extra nodal lymphoma diagnosed by pathology and immunohistochemistry in Weifang People’s Hospital were analyzed from January2015 to January 2017. The age,sex,primary site,pathological classification and other aspects were summarized and analyzed. Seventy-six patients with extranodal lymphoma who met the inclusion criteria were selected to observe the overall response rate,overall survival time and progression free survival time. Results(1)Clinical characteristics: in 89 cases of extra nodal lymphoma,the median age was 55 years old( 14 years old 89 years old);the proportion of men and women was 1. 2∶ 1;the first site was common in the gastrointestinal tract,nose,tonsil,mammary gland,skin and other parts;the pathological type was mainly diffuse large B cell lymphoma( DLBCL),accounting for 58. 4%. There was no significant difference in gender and pathological types( P = 0. 638),and there was no statistical significance between different age groups and pathological types either( P = 0. 125).(2)Among the 76 cases of extranodal lymphoma who met the receiving standard,the progression-free survival( PFS) was 16 months,the overall survival( OS) was 27( 2 ~ 40) months,and overall response rate( ORR) was 88%. Conclusion The clinical manifestations of extra nodal lymphoma are varied,the symptoms and signs are not typical. It is easy to miss diagnosis and misdiagnosis. When the primary organ enlarges or the local mass is formed,we should pay attention to the diagnosis of pathological examination in time. In terms of treatment,individualized treatment should be formulated according to clinical manifestations and pathological typing. The classic chemotherapy regimen CHOP or R-CHOP has a good effect.

关 键 词：结外淋巴瘤 临床特征 病理类型 疗效 

分 类 号：R733.4[医药卫生—肿瘤]