孤立性浆细胞瘤预后相关因素探究  

Prognostic factors in solitary plasmacytoma

作　　者：李倩[1] 郭姗琦[1] 智亚芹[1] 赵伟鹏[1] 杨洪亮[1] 于泳[1] 王晓芳[1] 王国文[2] 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肿瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市300060 [2]天津医科大学肿瘤医院骨软肿瘤科

出　　处：《中国肿瘤临床》2015年第10期504-508,共5页Chinese Journal of Clinical Oncology

基　　金：天津市科技支撑计划重点项目(编号:13ZCZSY20300);天津市教委科研计划项目(编号:20140112)资助~~

摘　　要：目的:探究孤立性浆细胞瘤患者的临床特点、治疗方法及预后相关因素。方法:搜集2000年6月至2012年10月就诊于天津医科大学肿瘤医院的644例恶性浆细胞肿瘤患者的临床资料,并对其临床特点、治疗方案、预后因素等进行分析,其中孤立性浆细胞瘤(solitary plasmacytoma,SP)患者有66例占10.25%。结果:根据SP的发生部位可分为骨孤立性浆细胞瘤(solitary bone plasmacytoma,SBP)和髓外浆细胞瘤(extramedullary plasmacytoma,EMP)。SBP大部分发生在椎体,而髓外浆细胞瘤好发于上呼吸道。此外,两者在肿块大小、血清M蛋白水平、尿本周氏蛋白水平以及是否更易进展为多发性骨髓瘤(multiple myeloma,MM)等方面的差异均具有统计学意义(P<0.05)。多因素分析结果表明,SBP患者的肿块越大(d≥5 cm),其肿瘤的局部控制率(local control,LC)、无骨髓瘤进展生存期(multiple myeloma-free survival,MMFS)、总生存期(overall survival,OS)及无病进展生存期(progressionfree survival,PFS)越差;对于EMP患者来说,放疗以及血清β2-微球蛋白<3.5 mg/L是预后良好的因素。结论:肿块大小、血清M蛋白、尿本周氏蛋白、血清β2-微球蛋白水平可为临床判断SBP与EMP预后及指导治疗提供帮助。Objective：To investigate the clinical features, treatment strategies, and relative prognostic factors in 66 patients with solitary plasmacytoma （SP）. Methods：The data of 644 patients, who were diagnosed with pathologically proven plasmacytoma in Tianjin Medical University Cancer Institute and Hospital between June 2000 and October 2012, were collected. Sixty-six of these patients （10.25%） were evaluated as SP, including 45 solitary bone plasmacytoma （SBP） and 21 extramedullary plasmacytoma （EMP）. Results：SBP and EMP were the two clinical subsets of SP revealing the location of the lesion. SBP mostly occurred in the axial skeleton, whereas EMP was most frequently observed in the upper respiratory tract. The differences among tumor size, serum M-protein, and serumβ2-microglobulin exhibited statistical significance. Conclusion：Large tumor size （≥5 cm）, positive serum M-protein, and serumβ2-microglobulin were the factors that affected the prognosis of SBP patients. Radiotherapy and serumβ2-microglobulin〉3.5 mg/L were the favorable prognostic factors for EMP patients.

关 键 词：孤立性浆细胞瘤 骨孤立性浆细胞瘤 髓外浆细胞瘤 临床特点 预后 放疗 

分 类 号：R733.3[医药卫生—肿瘤]