14例结节性淋巴细胞为主型霍奇金淋巴瘤患者的临床病理特征与疗效分析  

The clinical and pathological characteristics of 14 patients＇ nodular lymphocyte predominant Hodgkin＇s lymphoma

作　　者：刘素[1] 马静[1] 岳园芳 李倩[1] 杨洪亮[1] 赵海丰[1] 赵伟鹏[1] 于泳[1] 王晓芳[1] 赵智刚[1] 王亚非[1] 张翼鷟[1] 

机构地区：[1]天津医科大学肿瘤医院血液科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,300060

出　　处：《中华血液学杂志》2015年第1期20-23,共4页Chinese Journal of Hematology

摘　　要：目的 探讨结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL）患者的临床病理特征及疗效.方法 收集14例NLPHL患者的临床资料,对其临床病理特征及近、远期疗效进行相关性分析.结果 14例患者均为初治者,男、女各7例,中位发病年龄38（13～ 54）岁,中位随访时间为55.5（23～189）个月.发病率占同期霍奇金淋巴瘤（HL）的6.3％（14/223）.免疫组织化学检查结果示14例患者CD20均呈（＋）/弱（＋）,CD30均（-）,仅1例患者呈CD15弱（＋）.14例患者中13例因自觉浅表淋巴结肿大就诊,所有患者惰性起病,病情进展缓慢.7例患者采用单纯化疗,7例患者采用放、化疗联合治疗.14例患者均有效,其中完全缓解（CR）＋未证实的CR（CRu） 12例.5年无疾病生存率为85.7％,5年总生存率为100.0％.单纯化疗与放、化疗联合治疗相比,不同的化疗方案相比,其近、远期疗效差异均无统计学意义（P值均＞0.05）.结论 NLPHL患者瘤细胞呈CD20（＋）/弱（＋）,CD30（-）,极少数患者呈CD15弱（＋）.NLPHL在HL患者中所占比例低,以中青年患者多见,起病缓慢,与经典型HL患者相比疗效较好.Objective To probe the clinical and pathological characteristics of nodular lymphocyte predominant Hodgkin lymphoma （NLPHL）.Method The pathologically confirmed 14 cases of NLPHL patients （since January 2001 to December 2012） were collected from Tianjin Medical University Cancer Hospital.The laboratory examinations＇ results,clinical manifestations,short-term and long-term outcomes of these cases were analyzed in this study.Results The immunohistochemistry of all cases showed CD20 （＋）/weak （＋） and CD30 （-）,most of them CD 15 （-）.The morbidity of NLPHL during the same period of Hodgkin＇s lymphoma （HL） was around 6.3%.The median age was 38 （13-54） years old,92.9% of the patients sought medical advice according to self-feeling of superficial lymph nodes.All patient＇ disease progressed slowly and the sizes of lymph nodes were within 3 cm.Of the 14 patients,7 patients were treated with chemotherapy and 7 patients chemoradiotherapy.The treatment results showed CR＋CRu rate as 85.7% and ORR 100.0%.The rates of 5-year event-free survival （EFS） and overall survival （OS） were 85.7% and 100.0% respectively.Short and long term efficacies between chemotherapy and chemoradiotherapy had no significant differences.Meanwhile,varieties chemotherapy regimens showed no significant effects on short-and long-term efficacies （P〉0.05）.Conclusions The pathologically confirmed 14 cases of NLPHL had the classical and tumorous maxi cell,which showed CD20 （＋）/weak（＋） and CD30 （-）,very few cases showed weak CD 15 （＋）.The incidence of NLPHL was low.The majority of the NLPHL patients were middle-aged and youth.Moreover,the better short-and long-term outcomes over classical HL ones were observed regardless of patients＇ stage.

关 键 词：霍奇金病 病理学 临床 治疗结果 结节性淋巴细胞为主型 

分 类 号：R733.1[医药卫生—肿瘤]