50例T细胞非霍奇金淋巴瘤的临床分析  

Clinical analysis of 50 patients with T-cell non-Hodgkin's lymphoma

作　　者：刘颖[1,2] 段显琳[1,2] 曲建华[1,2] 王蕾[1,2] 袁海龙[1,2] 江明[1,2] 

机构地区：[1]新疆医科大学第一附属医院血液病中心,新疆乌鲁木齐830054 [2]新疆维吾尔自治区血液病研究所,新疆乌鲁木齐830054

出　　处：《中国癌症杂志》2014年第7期550-556,共7页China Oncology

摘　　要：背景与目的:T细胞非霍奇金淋巴瘤(T-cell non-Hodgkin’s lymphoma,T-NHL)在亚洲国家相对高发,且其发病具有种族及地域特征。本研究旨在讨论新疆医科大学第一附属医院收治的T-NHL患者的发病特点、病理类型及生存情况。方法:收集2002年1月—2012年12月本院诊治的50例T-NHL患者,对发病特点、病理类型及生存情况进行分析。结果:T-NHL患者汉族37例,维吾尔族13例;最常见病理类型为结外NK/T细胞淋巴瘤(NK/T cell lymphoma,NK/TCL),共16例(32%)。儿童组患者病理类型均为T淋巴母细胞性白血病/淋巴瘤(T-lymphoblastic leukemia/lymphoma,T-LBL),青年组及中年组最常见类型为NK/TCL,老年组最常见类型为血管免疫母细胞性T细胞淋巴瘤(angioimmunoblastic T-cell lymphoma,AITL)。临床分期Ⅰ、Ⅱ期患者均为NK/TCL,Ⅲ、Ⅳ期患者最常见为周围T细胞淋巴瘤-非特指性(peripheral T-cell lymphomas-unspecified,PTCL-U)及AITL。汉族与维吾尔族患者最常见的病理类型分别为NK/TCL及T-LBL。全组患者的5年总生存率为39%。NK/TCL、间变性大细胞性淋巴瘤(anaplastic large cell lymphoma,ALCL)、AITL、PTCL-U和T-LBL的3年总生存率分别为71%、61%、53%、19%和7%(P<0.05);中年组、青年组、老年组和儿童组5年生存率分别为67%、35%、21%和0(P<0.05)。结论:新疆地区T-NHL可能具有独特的临床特征:总发病率与国内报道相似,高于国外报道,汉族发病率高于维吾尔族;病理类型构成与欧美国家存在较大差异;不同年龄组、分期及民族的病理类型分布存在显著差异。长期生存率低、不同病理类型及年龄组均是影响生存的重要因素。Background and purpose：T-cell non-Hodgkin’s lymphoma（T-NHL） has relatively high incidence in Asian countries, and the incidence rate showed an upward tendency. It has a dual characteristic of both ethnic and regional. We conducted this study in order to analyze the clinical characteristics, pathological type and survival of T-NHL in our hospital. Methods：Records of 50 cases with T-NHL treated from Jan. 2002 to Dec. 2012, were analyzed in terms of clinical characteristics, distribution of pathological type and survival. Results：Patients with T-NHL account for 24%of NHL cases in our study. Of the 50 cases, 37 were Han, 13 were Uygur;The most frequent type was NK/T cell lymphoma（NK/TCL）（16/50, 32%）. We performed pathological type for each age group：4 cases with children’s group were all T-lymphoblastic leukemia/lymphoma（T-LBL）（4/4,100%）, the most frequent type of youth and middle age group was NK/TCL（8/20, 40%;7/13, 53.8%）, as the senile group was angioimmunoblastic T-cell lymphoma（AITL）（6/13, 46.2%）. There was also a signiifcant difference in pathological type between the stage, with stageⅠ-Ⅱwere all NK/TCL（12/12, 100%）, stageⅢ-Ⅳwere observed with peripheral T-cell lymphomas-unspeciifed（PTCL-U）（9/38, 23.7%） and AITL（9/38, 23.7%）. The frequent type of Han was NK/TCL（14/37, 37.8%）, as the Uygur was T-LBL（5/13, 38.5%）. The median overall survival（OS） time was 12 （ranged 0-112） months. The 5 year OS rate was 39%. Both pathological type and age group were important factors influencing survival. The difference in outcome for the pathological type（P〈0.05）： NK/TCL and anaplastic large cell lymphoma（ALCL） had the better 3 year OS rates（71%, 61%）, but PTCL-U and T-LBL had poor prognosis（19%, 7%）. Age did a signiifcant effect on OS（P〈0.05）：children’s group had the worse 5-year OS rate （0%）, middle age group had a better prognosis （67%）, the OS of the youth group was 35%, for the senile group was 21%. Concl

关 键 词：T细胞非霍奇金淋巴瘤 病理类型 民族 总生存 

分 类 号：R733.4[医药卫生—肿瘤]