原发中枢神经系统淋巴瘤患者临床特征和疗效分析  

Clinical Characteristics and Outcome of Patients with Primary Central Nervous System Lymphoma

作　　者：朱忻[1] 高敏洁 邹中华[1] 包睿康[1] 陈杰[1] 史建平[1] 周俊东[1] 吴锦昌[1] 薛景[1] ZHU Xin;GAO Min-jie;ZOU Zhong-hua;BAO Rui-kang;CHEN Jie;SHI Jian-ping;ZHOU Jun-dong;WU Jinchang;XUE Jing(Department of Radio-Oncology,Nanjing Medical University Affiliated Suzhou Hospital,Suzhou,Jiangsu,215001,China)

机构地区：[1]南京医科大学附属苏州医院肿瘤放疗科,江苏苏州215001

出　　处：《中国血液流变学杂志》2019年第4期442-446,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)患者的临床特征、病理情况和预后因素.方法回顾性分析2011年-2018年诊断为PCNSL的15例患者,患者分别接受了手术、化疗、全脑放疗(WBRT)等综合治疗.结果15例患者的中位年龄为71岁(范围35~88岁).CD10,Bcl6,MUM1,Bcl2和MYC的蛋白表达分别占0%,57.1%,57.1%,100%和33.3%,有1例生发中心B细胞(GCB)和2例双重表达(MYC+/Bcl2+)淋巴瘤.12例患者为多发性脑病变.分别有7例,4例和3例患者接受了一线WBRT,二线WBRT和手术后巩固WBRT的治疗.中位随访时间为46.0个月,中位生存时间40.0个月,2年生存率为53.3%.与OS相关的因素是WBRT参与的时机(P=0.013).结论影响PCNSL治疗结果的因素是治疗方案.Objective To explore the clinical characteristics,pathological features and prognostic factors of primary central nervous system lymphoma(PCNSL)patients.Methods A retrospective study of 15 patients diagnosed with PCNSL from 2011 to 2018 was conducted.15 patients were treated with either surgery,chemotherapy,whole brain radiotherapy(WBRT).Results There were 15 patients with a median age of 71 years(range 35-88 years).Protein expression of CD10,Bcl6,MUMI,Bcl2 and MYC were found in 0%,57.1%,57.1%,100%and 33.3%,respectively.Germinal center B cell(GCB)and double-expressor(MYC+/Bc12+)lymphomas were found in 1 and 2 patients,respectively.Multiple brain lesions were seen in 12 patients.First line therapy with WBRT,and second line therapy with W BRT,surgery followed with WBRT were given to 7,4 and 3 patients,respectively.Median follow-up time was 46 months,median overall survival(OS)time was 40 months,and a 2-year OS was 53.3%.Features associated with a prolonged OS were management of WBRT(P=0.013).Conclusion The factors afecting treatment outcomes in PCNSL was treatment regimen.

关 键 词：原发性中枢神经系统淋巴瘤 化疗 全脑放疗 GCB淋巴瘤 非GCB淋巴瘤 

分 类 号：R739.41[医药卫生—肿瘤]