乳腺弥漫大B细胞淋巴瘤临床特征及预后分析  

Clinical Features and Prognosis of Patients with Diffuse Large B-Cell Lymphoma of the Breast

作　　者：卫锦杰 王列样[1] 赵志强[1] 苏丽萍[1] WEI Jin-Jie;WANG Lie-Yang;ZHAO Zhi-Qiang;SU Li-Ping(Department of Hematology,Affiliated Tumor Hospital of Shanxi Medical University,Taiyuan 030013,Shanxi Province,China)

机构地区：[1]山西医科大学附属肿瘤医院血液科,山西太原030013

出　　处：《中国实验血液学杂志》2024年第5期1407-1413,共7页Journal of Experimental Hematology

摘　　要：目的:探讨乳腺弥漫大B细胞淋巴瘤(DLBCL)患者的临床特征及预后。方法:回顾性分析2013年1月至2023年1月山西省肿瘤医院收治的28例乳腺DLBCL患者的临床资料,其中原发性乳腺DLBCL(PB-DLBCL)13例、继发性乳腺DLBCL(SB-DLBCL)15例对其临床表现、实验室检查、病理学检查、治疗方案和随访资料进行统计学分析。结果:PB-DLBCL患者与SB-DLBCL患者在IPI评分、LDH、β_(2)-微球蛋白方面比较,差异有统计学意义(P<0.05)。接受规律治疗的23例乳腺DLBCL患者中,13例初始治疗达到完全缓解(PB-DLBCL 9例,SB-DLBCL 4例),至随访截止日期,11例患者复发或进展(PB-DLBCL 5例,SB-DLBCL 6例),9例患者死亡(PB-DLBCL 3例SBDLBCL 6例)。PB-DLBCL组、SB-DLBCL组患者5年OS率分别为(75.0±15.3)%和(32.3±17.1)%,PFS率分别为(59.1±19.8)%和0,PB-DLBCL患者5年OS率及PFS率均高于SB-DLBCL患者(P<0.05);联合中枢预防治疗组5年OS率高于单纯化疗组(P<0.05)。结论:乳腺DLBCL分为PB-DLBCL和SB-DLBCL两大类,PB-DLBCL与SB-DLBCL相比,具有IPI评分、LDH水平、β_(2)-微球蛋白较低等特点,且PB-DLBCL患者生存期更长。此外,接受中枢预防治疗患者的预后更为乐观。Objective:To explore the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma(DLBCL)of the breast.Methods:The clinical data of 28 DLBCL patients admitted to Shanxi Provincial Cancer Hospital from January 2013 to January 2023 were retrospectively analysed,including 13 cases of primary breast DLBCL(PB-DLBCL)and 15 cases of secondary breast DLBCL(SB-DLBCL),and the data of their clinical manifestations,laboratory tests,pathological examinations,treatment protocols,and follow-up were statistically analyzed.Results:There were significant differences in PI score,LDH level andβ_(2)-microglobulin between PB-DLBCL and SB-DLBCL patients(P<0.05).Among the 23 patients with breast DLBCL who received regular treatment,13 patients achieved complete remission(9 patients with PB-DLBCL and 4 patients with SB-DLBCL)after initial treatment.By the end of follow-up,11 patients relapsed or progressed(5 patients with PB DLBCL and 6 patients with SB-DLBCL)and 9 patients died(3 patients with PB DLBCL and 6 patients with SB-DLBCL).The 5-year OS rate was(75.0±15.3)%in PB-DLBCL group and(32.3±17.1)%in SB-DLBCL group.The 5-year PFS rate was(59.1±19.8)%in PB-DLBCL and 0%in SB-DLBCL group.The 5-year OS rate and PFS rate of PB-DLBCL patients were higher than those of SB-DLBCL patients(P<0.05);the 5-year OS rate of the combined central preventive treatment group was higher than that of the chemotherapy group(P<0.05).Conclusion:Breast DLBCL is divided into two categories:PB-DLBCL and SB-DLBCL.Compared with SB-DLBCL,PB-DLBCL has the characteristics of lower IPI score,LDH,andβ_(2)-microglobulin levels.PB DLBCL patients have a longer survival period.In addition,the prognosis of patients receiving central preventive treatment is more optimistic.

关 键 词：乳腺肿瘤 弥漫大B细胞淋巴瘤 临床特征 预后 

分 类 号：R737.9[医药卫生—肿瘤] R733.1[医药卫生—临床医学]