鼻型NK/T细胞淋巴瘤临床病理特征及预后分析

Analysis of clinicopathologic characteristics and prognostic factors of nasal type NK/T cell Lymphoma .

目的探讨鼻型NK/T细胞淋巴瘤临床病理特征及预后影响因素。方法回顾性分析经病理证实的31例该病患者的临床资料。结果鼻型NK/T细胞淋巴瘤容易误诊;3年及5年生存率分别为58.1%和33.3%;随着分期增高,生存率明显下降;有B症状者或IPI评分≥2者,其生存率分别显著低于无B症状者或IPI评分<2者;综合治疗组3年生存率显著高于单纯化疗组。结论鼻型NK/T细胞淋巴瘤的诊断应结合其临床特征、形态学、免疫表型及遗传学改变综合确定;AnnArbor分期、IPI及B症状是影响预后的重要因素;综合治疗可能是目前最佳的治疗选择。

Objective To investigate clinical and pathologic features and prognostic factors of nasal type NK/T cell lymphoma. Methods The clinical data of 31 patients with this disease admitted and treated from January 1993 to October 2003 in the Second Hospital and the First Hospital of Xi,an Jiaotong University were analyzed retrospectively. The diagnosis was confirmed histopathologically. Results The misdiagnosis of nasal type NK/T cell lymphoma is often encountered both in clinic and pathology. Of all 31 cases, the overall 3-year and 5-year survival rates were 58.1%(18/31) and 33.3%(5/15), respectively. The survival rates decreased with the progression of the clinical stages; B symptom and international prognostic factors index (IPI) were statistically negative relationship with prognosis. Compared with chemotherapy alone, there was a higher 3-year survival rates in combined modality therapy (CMT) group. Conclusion Effective measures to avoid misdiagnosis lies in mastering the clinical features, morphology, immunology and genetics of this disease. Ann Arbor staging, IPI and B symptom are important prognostic factors and CMT may be a optimal selection for treatment of nasal type NK/T cell lymphoma.