颌面部结外非霍奇金淋巴瘤临床病理分析  

Clinicopathological Analysis of Maxillofacial Extranodal Non-Hodgkin’s Lymphoma

作　　者：米洪燕 王玫月 刘孟哲 李锐[1] MI Hongyan;WANG Meiyue;LIU Mengzhe;LI Rui(Department of Stomatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Academy of Medical Sciences,Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院口腔颌面外科,河南郑州450000 [2]郑州大学医学科学院,河南郑州450000

出　　处：《河南医学研究》2022年第22期4053-4057,共5页Henan Medical Research

基　　金：国家自然科学基金(U1904145,81901039);河南省医学科技攻关(重点)项目(SBGJ202002073)。

摘　　要：目的研究颌面部结外非霍奇金淋巴瘤(ENHL)的临床体征、影像学表现及病理学特征,为ENHL的临床诊断提供依据。方法收集2013年1月至2021年4月郑州大学第一附属医院确诊的70例口腔颌面部ENHL患者的临床资料,分析患者的性别、发病年龄、发病部位、首发症状、组织学类型、影像学特征并分析SUV_(max)值与Ki-67的相关性。结果70例病例中男35例,女35例。发病年龄40~79(53.64±19.22)岁。腮腺(30%)是口腔颌面部最常受累的部位,其次是咽淋巴环处的腭部及舌根(22.86%)。弥漫大B细胞性淋巴瘤(32.86%)是最常见的组织学类型。CT平扫示瘤体呈均匀软组织密度,边界不清,增强扫描后轻中度强化;MRI主要表现为T_(1)WI等信号或低信号,T_(2)WI等信号或高信号。PET-CT的SUV_(max)值与Ki-67增殖指数呈正相关(r=0.522,P=0.015)。结论目前ENHL首诊确诊率低,发病呈年轻化趋势;临床表现不具特异性,但与发病部位和组织学类型有一定关联;组织病理学检查是诊断颌面部ENHL的金标准,^(18)F-FDG PET-CT的SUV_(max)值具有评估肿瘤细胞的增殖活性的临床意义。Objective To study the clinical signs,imaging manifestations and pathological features of maxillofacial extranodal non-Hodgkin lymphoma(ENHL)in order to provide basis for the clinical diagnosis of ENHL.Methods The clinical data of 70 patients with oral and maxillofacial ENHL diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2013 to April 2021 were collected.The gender,age,site,initial symptoms,imaging features,pathological types and immunophenotypes of the patients were analyzed.Results Among the 70 patients,35 were males and 35 were females.The onset was 40-79(53.64±19.22)years old.The parotid gland(30%)was the most frequently involved part of the oral and maxillofacial region,followed by the palate and the base of the tongue at the pharyngeal lymphatic ring(22.86%).Diffuse large B-cell lymphoma(32.86%)is the most common histological type.CT scan showed that the tumor had uniform soft tissue density with unclear boundary,mild to moderate enhancement after enhanced scan.MRI mainly shows isointensity or hypointensity on T_(1)WI and isointensity or hyperintensity on T_(2)WI.The SUV_(max) of PET-CT was positively correlated with the Ki-67 proliferation index(r=0.522,P=0.015).Conclusion At present,the first diagnosis rate of ENHL is low,and the incidence tends to be younger.The clinical manifestations are not specific,but are related to the location of the disease and histological type.Histopatholgical examination is the gold standard for the diagnosis of maxillofacial ENHL.The SUV_(max) value of ^(18)F-FDG PET-CT has clinical significance in evaluating the proliferative activity of tumor cells.

关 键 词：结外非霍奇金淋巴瘤 颌面部 SUV max值 

分 类 号：R78[医药卫生—口腔医学]