原发性乳腺淋巴瘤诊疗及预后的研究进展  

Research progress on diagnosis and prognosis of primary breast lymphoma

作　　者：沈朝妍[1] 张冠禹 王伟[2] SHEN Chao-yan;ZHANG Guan-yu;WANG Wei(Jining First People's Hospital,Jining272111,P.R.China;School of Clinical Medicine,Jining Medical University,Jining272000,P.R.China)

机构地区：[1]济宁市第一人民医院影像科,山东济宁272111 [2]济宁市第一人民医院乳腺甲状腺外科,山东济宁272111 [3]济宁医学院临床医学院,山东济宁272000

出　　处：《中华肿瘤防治杂志》2020年第16期1344-1349,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的原发性乳腺淋巴瘤(primary breast lymphoma,PBL)是一种罕见的血液系统疾病,在临床上常与乳腺恶性肿瘤混淆。本研究分析近5年国内外有关PBL的研究,明确其诊断、治疗以及预后的特点,提高临床工作中对PBL的认识。方法应用PubMed、中国知网以及万方数据库检索系统,以中文关键词“乳腺、淋巴瘤”和英文关键词“breast、lymphoma、diagnosis、treatment”,检索2014-01-2019-08发表的相关文献,共检索中文文献105篇,英文文献289篇。纳入标准:(1)与PBL的诊断、治疗以及预后有关的研究;(2)有特色的个案研究;(3)病例数较多的临床实验。排除标准:(1)非中文核心期刊和英文非SCI收录的文献;(2)作者所属单位为基层医院;(3)结果重复且相对陈旧的临床实验。根据纳入和排除标准,最终38篇文献纳入分析。结果PBL是指在没有先前诊断为乳房外淋巴瘤且同时不存在其他广泛疾病的情况下发生在乳房中的原发性淋巴瘤,其发病率低,容易与乳腺癌混淆。PBL女性的发病率高,一般以单侧乳房肿块为首发症状;影像学诊断缺乏特异性,细针穿刺及病理学检查为金标准;局部手术可用于病理诊断,化疗联合靶向治疗是目前的主要治疗方式,辅助放疗可以改善PBL患者的预后,降低复发风险,但是对于预防性鞘内注射目前有很大争议;预后与病理类型、临床分期以及是否有结外器官受累有关。结论PBL的发病率低,确诊需要依靠病理学检查,临床中有可疑的淋巴瘤患者应与乳腺癌患者区分,避免误诊。OBJECTIVE Primary breast lymphoma(PBL)is a rare disease of the blood,which is often confused with breast malignant tumor in the clinical.This study explored the research on PBL in the past 5years at home and abroad to clarify the characteristics of its diagnosis,treatment and prognosis,so as to improve the awareness of PBL in clinical work.METHODS Using PubMed,CNKI and WANGFANG DATA to search relevant literatures published from January 2014 to August 2019,with"breast,lymphoma"and"breast,diagnosis and treatment"as keywords,among which 105were in Chinese and 289in English.Inclusion criteria:(1)studies related to the diagnosis,treatment,and prognosis of PBL;(2)characteristic case reports;(3)clinical trials with large number of cases.Exclusion criteria:(1)non-chinese core journals and non-sci literatures in English;(2)the author belongs to the grass-roots hospital articles;(3)repeated and relatively obsolete clinical trials.According to the inclusion and exclusion criteria,38references were included in the analysis.RESULTS PBL refers to the primary lymphoma occurring in the breast in the absence of previously diagnosed extramural lymphoma and the absence of co-existing extensive diseases,with a low incidence and easily confused with breast cancer.The incidence is high in women,generally with unilateral breast lump as the first symptom.Imaging diagnosis lack of specificity,mainly fine needle puncture and pathological examination as the gold standard for diagnosis.Local surgery can be used for pathological diagnosis.Chemotherapy combined with targeted therapy is the main treatment method at present.Assisted radiotherapy can improve the prognosis of patients with PBL and reduce the risk of recurrence.The prognosis is related to pathological type,clinical stage,and the presence of extragonal organ involvement.CONCLUSIONS The incidence of PBL is low,and the diagnosis needs to rely on pathological examination.Patients with suspected lymphoma in the clinic should be distinguished from breast cancer.They have different treat

关 键 词：原发性乳腺淋巴瘤 弥漫大B细胞淋巴瘤 诊断 治疗 预后 综述文献 

分 类 号：R737.9[医药卫生—肿瘤]