原发性肺淋巴瘤临床特征及预后分析  

Clinical Characteristics and Prognosis of Primary Pulmonary Lymphoma

作　　者：冯友繁[1] 张媛媛 魏小芳 张启科[1] 赵丽[3,4] 梁小芹 伏媛[1] 刘菲[1] 赵阳阳 黄秀娟 李青芬[1] FENG You-Fan;ZHANG Yuan-Yuan;WEI Xiao-Fang;ZHANG Qi-Ke;ZHAO Li;LIANG Xiao-Qin;FU Yuan;LIU Fei;ZHAO Yang-Yang;HUANG Xiu-Juan;LI Qing-Fen(Department of Hematology,Gansu Provincial Hospital;The First School of Clinical Medicine,Gansu University of Chinese Medicine;The First School of Clinical Medicine,Lanzhou University;Gansu Clinical Medical Research Center for Molecular Diagnosis and Treatment of Hematological Diseases;Department of Pathology,Gansu Provincial Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]甘肃省人民医院血液科 [2]甘肃中医药大学第一临床医学院 [3]兰州大学第一临床医学院 [4]甘肃省血液病分子诊断与治疗临床医学研究中心 [5]甘肃省人民医院病理科,甘肃兰州730000

出　　处：《中国实验血液学杂志》2025年第2期387-392,共6页Journal of Experimental Hematology

基　　金：甘肃省自然科学基金(22JR5RA660)。

摘　　要：目的:探讨原发性肺淋巴瘤(PPL)的临床特点及其预后。方法:收集甘肃省人民医院2013年1月至2023年6月收治的17例PPL患者的临床资料,对其临床特点及其预后进行回顾性分析和总结。结果:17例患者的中位发病年龄为56(29-73)岁;男性8例,女性9例;按照Ann Arbor临床分期,Ⅰ-Ⅱ期患者9例,Ⅲ-Ⅳ期患者8例;IPI评分0-2分的患者14例,3-4分的患者3例。17例患者首诊时均有症状,首发症状大多为咳嗽,6例患者有B症状。17例患者中,弥漫大B细胞淋巴瘤(DLBCL)8例,MALT淋巴瘤5例,灰区淋巴瘤(GZL)1例,霍奇金淋巴瘤(HL)3例。17例患者中,15例接受化疗,其中3例接受自体造血干细胞移植,3例接受放疗,2例未治疗。中位接受化疗疗程数为6(2-8)疗程。评估近期疗效,12例患者达完全缓解(CR),3例部分缓解(PR)。年龄、病理亚型、性别、分期、β2-微球蛋白(β2-MG)水平、乳酸脱氢酶(LDH)水平与完全缓解率均无相关性(P>0.05),IPI评分与近期完全缓解率有相关性(P<0.05)。中位随访31(2-102)个月,12例CR患者中1例因感染新冠死亡,其余均存活;3例未达CR的患者中,1例疾病进展后死亡,另2例存活;2例未治疗的患者中,1例于确诊1年后死亡。中位无进展生存(PFS)时间及总生存(OS)时间均为31(2-102)个月。结论:PPL发病率低,且该病无特异性临床表现,极易漏诊及误诊,病理亚型以MALT淋巴瘤及DLBCL为主,治疗以联合化疗为主,IPI评分与疗效相关。Objective:To investigate the clinical characteristics and prognosis of primary pulmonary lymphoma(PPL).Methods:The clinical data of 17 patients with PPL admitted to Gansu Provincial Hospital from January 2013 to June 2023 were collected,and their clinical characteristics and prognosis were retrospectively analyzed and summarized.Results:The median age of the 17 patients was 56(29-73)years old.There were 8 males and 9 females.According to Ann Arbor staging system,there were 9 patients with stage I-II and 8 patients with stage III-IV.There were 14 patients with IPI score of 0-2 and 3 patients with IPI score of 3-4.All 17 patients had symptoms at the initial diagnosis,most of the first symptoms were cough,and 6 patients had B symptoms.Among the 17 patients,there were 8 cases of diffuse large B-cell lymphoma(DLBCL),5 cases of mucosa-associated lymphoid tissue(MALT)lymphoma,1 case of gray zone lymphoma(GZL),and 3 cases of Hodgkin′s lymphoma(HL).15 patients received chemotherapy,of which 3 cases received autologous hematopoietic stem cell transplantation(ASCT)and 3 cases received radiotherapy;2 patients did not receive treatment.The median number of chemotherapy courses was 6(2-8).The short-term efficacy was evaluated,12 patients achieved complete remission(CR)and 3 patients achieved partial remission(PR).The age,pathological subtype,sex,Ann Arbor stage,β2-microglobulin(β2-MG)level,lactate dehydrogenase(LDH)level were not correlated with CR rate(P>0.05),while IPI score was correlated with recent CR rate(P<0.05).The median follow-up time was 31(2-102)months.One of the 12 CR patients died of COVID-19,and the rest survived.Among the 3 patients who did not reach CR,1 died after disease progression,while the other 2 survived.One of the 2 untreated patients died one year after diagnosis.Both the median progression-free survival(PFS)time and overall survival(OS)time of the 17 patients were both 31(2-102)months.Conclusion:The incidence of PPL is low,and the disease has no specific clinical manifestations,which is easily mi

关 键 词：原发性肺淋巴瘤 临床特征 预后 

分 类 号：R734.2[医药卫生—肿瘤]