儿童非霍奇金淋巴瘤的临床及病理特点  

Clinical and pathological features of non-Hodgkin′s lymphoma in children

作　　者：夏敏[1] 王雪莉[2] 郑月 李红[3] 张泓[1] Xia Min;Wang Xueli;Zheng Yue;Li Hong;Zhang Hong(Department of Clinical Laboratory,Shanghai Children′s Hospital/Children′s Hospital of Shanghai Jiaotong University,Shanghai 200040,China;Department of Pathology,Shanghai Children′s Hospital/Children′s Hospital of Shanghai Jiaotong University,Shanghai 200040,China;Department of Hematology,Shanghai Children′s Hospital/Children′s Hospital of Shanghai Jiaotong University,Shanghai 200040,China)

机构地区：[1]上海市儿童医院/上海交通大学附属儿童医院检验科,200040 [2]上海市儿童医院/上海交通大学附属儿童医院病理科,200040 [3]上海市儿童医院/上海交通大学附属儿童医院血液肿瘤科,200040

出　　处：《中华实用儿科临床杂志》2021年第3期191-194,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：上海市卫生计生系统重要薄弱学科建设(2015ZB0203)。

摘　　要：目的对73例儿童非霍奇金淋巴瘤临床资料进行回顾性分析,明确其临床特点、病理类型及与疗效的关系。方法收集2014年10月至2018年10月上海市儿童医院73例初诊非霍奇金淋巴瘤患儿资料,其中男52例,女21例;年龄2~13岁。对所有患儿发病的起始或累积器官、病理诊断、疾病分期、手术及疗效等进行综合评估。结果73例儿童非霍奇金淋巴瘤中66例获得明确的病理诊断,其中38例由手术确诊,20例由活检确诊,且均通过免疫组织化学明确,8例通过流式细胞术等确诊;另7例中的6例获大致病理分类,仅1例分类不明。66例明确病例中以伯基特淋巴瘤最多为31例,其余依次为T-淋巴母细胞型14例、间变大淋巴瘤7例、B-淋巴母细胞型6例、弥漫大B淋巴瘤5例、结外鼻型自然杀伤/T细胞淋巴瘤1例、母细胞性浆细胞样树突细胞瘤1例和脂膜炎样T淋巴瘤1例;起始部位或累积器官涉及多个器官,以颈部(20例)、腹腔(15例)、纵隔(6例)等最为多见;临床转归与疗效中Ⅱ期、Ⅲ期和Ⅳ期的完全缓解率分别为100.0%、85.1%和72.2%;Ⅲ期和Ⅳ期患儿无事件生存率低于Ⅱ期组患儿(80.9%比66.7%比100.0%),病理类型分组结果显示淋巴母细胞淋巴瘤较伯基特淋巴瘤无事件生存率更低(73.7%比90.3%),但差异均无统计学意义(均P>0.05)。结论儿童非霍奇金淋巴瘤男性发病多,婴幼儿少见,病理类型较成人单纯,以伯基特淋巴瘤最多,临床分期和病理类型与预后可能相关。Objective To retrospectively analyze the clinical data of 73 children with non-Hodgkin′s lymphoma to determine its clinical features,pathological types and relationship with efficacy.Methods In Shanghai Children′s Hospital from October 2014 to October 2018,73 children with newly diagnosed non-Hodgkin′s lymphoma were enrolled for a retrospective study,with 52 males and 21 females,aged between 2 and 13 years old,so as to comprehensively assess cumulative organs,pathological diagnosis,stage of disease,surgery and efficacy.Results Among the 73 children with non-Hodgkin′s lymphoma,66 cases had a clear pathological diagnosis,including 38 cases of surgical pathology and 20 cases of biopsy pathology.All of them were confirmed by immunohistochemisty,and 8 cases were determined by flow cytometry.Meanwhile,6 cases of the rest 7 cases obtained approximate pathological classification.Only 1 case was unknown.Among the 66 cases,Burkitt lymphoma was the most common in 31 cases,followed by 14 cases of T-lymphocyte type,7 cases of enlarged lymphoma,6 cases of B-lymphocyte type,5 cases of diffuse large B lymphoma,1 case of extranodal natural killer/T cell lymphoma-nasal type,1 case of blastic plasmacytoid dendritic cell neoplasm,and 1 case of panniculitis-like T lymphoma.The initial site or cumulative organ involved multiple organs,with most common in neck(20 cases),abdominal cavity(15 cases),and mediastinum(6 cases).In view of outcomes and efficacy,the complete remission rates of stageⅡ,Ⅲ,andⅣin clinical were 100.0%,85.1%,and 72.2%,respectively.The event-free survival rates in stageⅢandⅣwere lower than those in stageⅡ(80.9%vs.66.7%vs.100.0%).From the perspective of the main pathological types grouping,the results revealed that lymphoblastic lymphoma had a lower event-free survival rate than Burkitt′s lymphoma(73.7%vs.90.3%),while there was no statistical significance(all P>0.05).Conclusions Non-Hodgkin′s lymphoma in children is more common in men,and less common in infants and young children.Pathological ty

关 键 词：儿童 非霍奇金淋巴瘤 临床特点 病理类型 

分 类 号：R733.1[医药卫生—肿瘤]