原发性乳腺弥漫大B细胞淋巴瘤的预后分析  

Prognosis analysis of primary breast diffuse large B cell lymphoma

作　　者：朱悦红 孟文静 何丽宏 贾勇圣 佟仲生 Zhu Yuehong;Meng Wenjing;He Lihong;Jia Yongsheng;Tong Zhongsheng(Department of Bretist Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Key Laboratory of Cancer Prevention and Therapy, Tianjin , Tianjin's Clinical Research Center for Cancer, Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院乳腺内科/国家肿瘤临床医学研究中心/乳腺癌防治教育部重点实验室/天津市"肿瘤防治"重点实验室/天津市恶性肿瘤临床医学研究中心,300060

出　　处：《中华肿瘤杂志》2019年第3期235-240,共6页Chinese Journal of Oncology

基　　金：国家科技支撑计划课题(2015BAI12B00);天津市卫生局科技基金(2015KZ089);天津医科大学科学基金(2016KYZQ05).

摘　　要：目的探讨原发性乳腺弥漫大B细胞淋巴瘤(PB-DLBCL)的临床特征、治疗和预后。方法回顾性分析2004年1月1日至2017年1月31日天津医科大学肿瘤医院收治的68例PB-DLBCL患者的临床病理资料。68例患者中,男性1例,女性67例;中位年龄56岁。Ann Arbor临床分期为Ⅰ~Ⅱ期46例,Ⅲ~Ⅳ期22例。有B症状11例,无B症状57例。采用Kaplan-Meier法进行单因素分析,并计算5年总生存率和5年无进展生存率,组间比较采用log rank检验,多因素分析采用Cox回归模型。结果全组患者的1、3、5年生存率分别为84.0%、78.0%和73.0%,1、3、5年无进展生存率分别为80.0%、71.0%和51.0%。单因素分析显示,美国东部肿瘤协作组评分、Ann Arbor临床分期、国际预后指数(IPI)评分、危险分层、B症状、β2微球蛋白水平、肿物大小、化疗周期数与PB-DLBCL患者的总生存均有关(均P<0.05);Ann Arbor临床分期、IPI评分、危险分层、B症状与PB-DLBCL患者的无进展生存均有关(均P<0.05)。多因素分析显示,Ann Arbor临床分期是影响PB-DLBCL患者总生存的独立预后因素(P=0.029),B症状是影响PB-DLBCL患者无进展生存的独立预后因素(P=0.028)。结论 PB-DLBCL患者的总体预后相对较好,Ann Arbor临床分期和B症状分别是影响PB-DLBCL患者总生存和无进展生存的独立预后因素。Objective To investigate the clinical characteristics, therapy modality and prognosis of primary breast diffuse large B-cell lymphoma(PB-DLBCL). Methods A total of 68 patients with PB-DLBCL treated in Tianjin Medical University Cancer Institute and Hospital were enrolled between January 1, 2004 and January 31, 2017. Clinicopathological data were retrospectively analyzed. 67 patients were female and only one male. The median age was 56 years old. 46 patients had Ann Arbor clinical stageⅠ~Ⅱ disease, and the other 22 were stage Ⅲ~Ⅳ. The patients with and without B symptom were 11 and 57, respectively. Kaplan-Meier method was used for univariate analysis to calculate the 5-year overall survival (OS) rate and 5-year progress-free survival (PFS) rate, compared using the log rank test. Cox regression analysis was used for multivariate analysis. Results The 1, 3, 5-year OS rate were 84.0%, 78.0% and 73.0%, and 1, 3, 5-year PFS rate were 80.0%, 71.0% and 51.0%, respectively. Univariate analysis indicated that eastern cooperative oncology group (ECOG) score, Ann Arbor clinical stage, international prognostic index (IPI) score, risk stratification, B symptom,β2-microglobulin(β2-MG) level, size of the tumor and cycles of chemotherapy were prognostic factors for OS (all P<0.05), and Ann Arbor clinical stage, IPI score, risk stratification and B symptom were prognostic factors for PFS (all P<0.05). Multivariate analysis indicated that Ann Arbor clinical stage was independent prognostic factor for OS(P=0.029) and B symptom was independent prognostic factor for PFS(P=0.028). Conclusions Prognosis of PB-DLBCL was relatively good. Ann Arbor clinical stage and B symptom were independent prognostic factors for OS and PFS, respectively.

关 键 词：淋巴瘤 原发性乳腺弥漫大B细胞淋巴瘤 结外淋巴瘤 临床病理特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]