儿童淋巴结外非霍奇金淋巴瘤52例临床分析

A CLINICAL ANALYSIS OF 52 CASES OF EXTRANODAL NON-HODGKIN'S LYMPHOMA IN CHILDREN

目的探讨儿童淋巴结外非霍奇金淋巴瘤的治疗方法及影响预后的因素。方法分析５２例儿童淋巴结外型非霍奇金淋巴瘤的临床资料。结果好发部位有鼻腔（２３．１％）和胃肠（１９．２％）。主要临床表现有病灶部位的肿块（８６．５％）和疼痛（７５％）。初次治疗达完全缓解为７５％，１年、２年和５年生存率分别为４２．３％、２６９％和２５．０％。综合治疗的１年、２年和５年生存率分别为４６．７％、３３．３％和３３．３％，高于局部治疗（手术或放疗）和单纯化疗者。年龄≥７岁、ⅠＥ期、低度恶性、无全身症状者各年生存率均分别高于＜７岁、ⅡＥ期以上、中高度恶性、有全身症状者。结论综合治疗较其他治疗方式为佳。年龄、Ｂ组表现、病期、恶性程度、治疗方式与预后有关。

PURPOSE To investigate methods of treatment of children's non-Hodgkin's lymphoma and the prognostic factors.METHODS Analysis of the clinical data of 52 cases of children's extranodal non-Hodgkin's lymphoma. All cases were confirmed by histological diagnosis.RESULTS Nasal cavity,stomach and intestines were the most common lesions. Focal swelling and pain were the major clinical manifestations. In the initial treatment,there was 75 % CR,the survival rate at 1,2, 5 years were 42. 3%, 26. 9% and 25% respectively. Combined therapy was better than any other regimen,giving survival rates of 46. 7%, 33. 3% and 33. 3%,better than cases treated by local modalities only (surgery or radiotherapy),or chemotherapy alone. The cases aged over 7 years,stage ⅠE,low malignancy,no general symptoms,had better prognosis than those under 7 years,stage ⅡE,moderate or high malignancy and general symptoms.CONCLUSIONS Combined treatment is better than other methods of treatment.Age,stage,grade of malignancy and treatment modality all had influence on prognosis.