原发性肝脏淋巴瘤19例临床病理学特点及预后分析  

Clinicopathological features and postoperative prognosis of primary liver lymphoma in 19 cases

作　　者：庞书杰 叶庆旺 施洋 杨宁 杨广顺 

机构地区：[1]东方肝胆外科医院肝外五科,上海200438 [2]苏州大学医学院,江苏苏州215000

出　　处：《肝胆胰外科杂志》2015年第6期502-505,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：十二五艾滋病和病毒性肝炎等重大传染病防治专项"肝癌抗复发转移治疗临床新体系的研究和应用推广"(20 12ZX10002-017)

摘　　要：目的研究原发性肝脏淋巴瘤的临床病理学及预后特点。方法回顾性分析我院2006年1月1日至2014年12月31日期间收治的经病理学确诊的19例原发性肝脏淋巴瘤患者的临床资料,总结其临床病理学特点、诊断及治疗方案,根据随访结果进行预后分析。结果 19例患者病理检查前均误诊为其他肝脏疾病。19例患者中,男8例（42.1%）,女11例（57.9%）,年龄17-79岁,中位年龄47岁。10例（52.6%）患者合并乙肝病毒感染,9例（47.4%）出现LDH升高,12例（63.1%）出现A/G倒置。17例手术患者术后中位生存时间50.8个月,95%CI：32.0-69.5,术后化疗与否生存时间有明显差异（P=0.048,〈0.1）。结论原发性肝脏淋巴瘤临床误诊率高,确诊赖以病理学检查,发病可能与HBV感染有关,术后辅以化疗可延长患者生存时间。Objective To investigate the clinicopathological features and postoperative prognosis of primary hepatic lymphoma （PHL）. Methods Nineteen patients with primary hepatic lymphoma confirmed by pathology were treated in our hospital between Jan. 1 2006 and Dec. 31 2014. Their clinical data were collected and analyzed retrospectively to sum up the clinicopathological features and therapeutic strategies of primary hepatic lymphoma, then prognosis analysis was conducted based on the follow-up outcomes. Results All 19 patients were misdiagnosed as other liver diseases before pathological examination. Among the 19 cases, 8 were man （42.1%） and 11 （57.9%） were women, with a median age of 47 years old （range 17-79 years）. In this study,10（52.6%） patients were accompanied with hepatitis B virus infection, 9 （47.4%） patients with an elevated LDH level, 12 patients （63.1%） with an inverted ratio of A/G. Postoperative median survival time was 50.8 mon with 95%CI： 32.0 - 69.5 mon. The chemotherapy group showed a better postoperative survival than the non-chemotherapy group （P=0.048, 〈0.1）. Conclusion Lack of specific clinical manifestations, misdiagnosis rate is high in PHL, and diagnosis should be confirmed by pathology. HBV infection may be related to the incidence of PHL. Postoperative chemotherapy may prolong the survival time of patients with PHL.

关 键 词：肝脏 淋巴瘤 乙型肝炎 化疗 预后 

分 类 号：R730.23[医药卫生—肿瘤]