肝脏非霍奇金淋巴瘤的临床分析

Clinical Analysis of Liver Non-Hodgkin's Lymphoma

背景与目的:非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL)累及肝脏在临床越来越多见,而对肝脏NHL的认识还不多。本研究分析肝脏NHL的发病特点、临床表现、诊断、治疗和预后。方法:1998年1月～2002年12月收治446例NHL,肝脏NHL45例,占9.6%。男性32例,女性13例,中位年龄50岁。对患者的临床资料、治疗方法和疗效进行分析。采用SPSS10.0软件分析生存情况。结果:免疫组化示T细胞来源24例,B细胞来源19例,2例来源不明。依国际工作分类(IWF),中度恶性占92%。临床表现主要是发热、黄疸、肝脾肿大、肝功能损害。治疗采用以化疗为主的综合治疗。全组患者中位生存期(MST)4个月,1年、2年生存率分别为22%和18%。结论:肝脏NHL早期诊断不易,治疗效果不佳,预后差。

BACKGROUND &OBJECTIVE: Incidence of liver non-Hodgkins lympho ma (NHL)is increasing. This study was to explore clinical features,diagnosis,tre atment,and prognosis of liver NHL. METHODS: Records of 45 patients with liver NH L treated in our hospital from Jan. 1998 to May 2002,9.6%of all NHL patients tr eated in the same period,were retrospectively analyzed with statistic software p ackage of SPSS10.0. RESULTS: Of 45 patients,32 were male,and 13 were female,the median age was 50 years. Immunophenotyping revealed that 24 cases were T cell or iginal,19 were B cell original,and 2 were undefined. According to International Work Formulation (IWF),92%of 45 patients belonged to intermediate-grade. Clini cal features of liver NHL were presented with fever,jaundice,hepatosplenomegalia ,and liver dysfunction. Combination treatment based on chemotherapy was the majo r therapy. Median survival time was 4 months,overall 1-, and 2-year survival r ates were 22%,and 18%. CONCLUSION: Early diagnose liver NHL is difficult,its t reatment effect and prognosis are poor,combination therapy should be given as ea rly as possible.