咽淋巴环弥漫大B细胞淋巴瘤66例临床特征及预后分析  

Clinical features and prognostic analysis of 66 patients with pharyngeal lymphatic ring diffuse large B-cell lymphoma

作　　者：张海亮[1] 兰胜民[2] 曹建忠[2] 王宏卫[2] 张宁[2] 于剑飞[2] 任淑惠[2] 鲁萍[2] 

机构地区：[1]山西医科大学研究生学院,太原030001 [2]山西省肿瘤医院放疗中心

出　　处：《肿瘤研究与临床》2015年第12期816-819,共4页Cancer Research and Clinic

摘　　要：目的 分析咽淋巴环弥漫大B细胞淋巴瘤（DLBCL）的临床特征、预后及其影响因素。方法 回顾性分析经病理诊断的66例咽淋巴环DLBCL患者的临床资料，其中肿瘤位于鼻咽13例，扁桃体49例，舌根4例；Ⅰ期6例，Ⅱ期48例，Ⅲ期6例，Ⅳ期6例。Ⅰ～Ⅱ期患者接受化疗加受累野照射，Ⅲ～Ⅳ期患者以化疗为主。结果 咽淋巴环DLBCL多为Ⅱ期，表现为邻近器官受侵，少见全身症状、脾受侵及乳酸脱氢酶升高。3、5年总生存率分别为77.9 %、66.9 %。单因素分析显示，乳酸脱氢酶升高、临床分期Ⅲ～Ⅳ期、国际预后指数（IPI）≥1分及ECOG评分≥2分是DLBCL患者的不良预后因素。多因素分析显示，IPI≥1分是咽淋巴环DLBCL不良预后的影响因素。结论 咽淋巴环DLBCL有独特的临床特征，IPI评分是影响预后的因素。Objective To analyze the clinical features, prognosis and its influence factors of pharyngeal lymphatic ring diffuse large B-cell lymphoma. Methods 66 cases diagnosed with pharyngeal lymphatic ring diffuse large B-cell lymphoma were analyzed retrospectively, including 13 nasopharynx cases, 49 tonsil cases and 4 tongue root cases. The patients in Ⅰ-Ⅱ phases were mainly treated with chemotherapy plus involvement wild illuminate, and the patients in Ⅲ-Ⅳ phases were mainly treated with chemotherapy. Results Most patients with pharyngeal lymphatic ring diffuse large B-cell lymphoma were in phase Ⅱ, showing that neighboring organs were infiltrated, but rare systemic symptom, spleen were invaded and lactic acid dehydrogenase was increased. The overall survival rates of 3 and 5 years in patients with pharyngeal lymphatic ring diffuse large B-cell lymphoma were 77.9 % and 66.9 % respectively. The single-factor analysis indicated that the lactic acid dehydrogenase ≥ 248 U/L, the international prognostic index （IPI） score ≥1, and ECOG score ≥2 were the adverse prognosis influence factors. The multiple-factor analysis showed that the IPI score ≥ 1 was related to poor prognosis of pharyngeal lymphatic ring diffuse large B-cell lymphoma. Conclusion Pharyngeal lymphatic ring diffuse large B-cell lymphoma has unique clinical characteristics, and IPI score can influence the prognosis.

关 键 词：咽淋巴环 淋巴瘤 大B细胞 弥漫型 

分 类 号：R739.6[医药卫生—肿瘤]