非霍奇金淋巴瘤641例临床分析

Clinical analysis of 641 cases of non-Hodgkin's lymphomas

目的:探讨非霍奇金淋巴瘤(NHL)的临床特点。方法:回顾性分析641例NHL的发病情况、起病部位、病理类型、临床分期及实验室等相关资料。结果:平均发病年龄48.6岁,男性多见;结性起病302例(47.1%),颈部、锁骨上淋巴结多见(32.8%);结外起病339例(52.9%),常见部位依次为胃肠道(17.6%)、Waldeyer环(9.8%)、脾脏(4.5%)、皮肤(4.2%)、中枢神经系统(3.9%)。免疫分型:B细胞395例(61.7%),T细胞238例(37.1%),非T非B细胞8例(1.2%);B细胞淋巴瘤中常见的病理类型依次是弥漫性大B细胞淋巴瘤(DLBCL)(30.9%)、黏膜相关淋巴组织淋巴瘤(MALT)(15.0%),滤泡淋巴瘤(FL)(8.1%);T细胞淋巴瘤中最常见的是外周T细胞淋巴瘤(PTCL)(24.3%),其次是T淋巴母细胞淋巴瘤(T-LBL)(5.5%),间变大细胞淋巴瘤(ALCL)(2.0%)。血清乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)和糖链蛋白125(CA125)检查异常升高阳性率分别为42.5%、54.6%和61.8%,且在分期Ⅲ～Ⅳ期中的表达水平明显高于Ⅰ～Ⅱ期(P<0.05)。结论:NHL发病以中老年多见,结外起病多于结性起病,B细胞淋巴瘤多于T细胞淋巴瘤。

Objective： To analyze the clinical characteristics of non-Hodgkin＇s Lymphoma （NHL）. Methods： All 641 cases of NHL were analyzed according to the clinical states, involved sites, classification of lymphoma, clinical stage and laboratory investigations, Results： The average age of patients was 48.6 years old, Out of 641 NHL cases, 302 cases （47.1%） were classified as nodal lymphoma,and the most common nodal sites of which were in the cervical and supraclavicular parts; 339 cases （52.9%） were classi- fied as extranodal lymphoma which spread to areas of gastrointestinal tract, Waldeyer-ring, spleen, skin and central nervous system. The presents of different subtypes were as follows ： 395 cases （61,7%） of B-cell, 238 （37.1%） of T-cell and 8 （1.2%） of non-B and non-T-cell, respectively, The subtypes of B-cell lymphoma were as follows： diffuse large β-cell lymphoma （DLBCL 30.8%）, mucosa associated lymphoid tissue （MALT l 5.0%） and follicular lymphoma （FL 8.1%） ; The subtypes of T-cell lymphoma were as follows： peripheral T-cell lymphoma （PTCL 24.3%）, T-lymphoblastic lymphoma （T-LBL 5.5%） and anaplastic large cell lymphoma （ALCL 2.2%）, The positive rate of abnormal expression of serum lactic acid dehydrogenas （LDH）, β2-microglobulin （β2-MG）and catenin 125 （CA125） was 42.5%, 54.6% and 61.8%, respectively. The levels of them in stages Ⅲ-Ⅳ were higher than those in stages Ⅰ-Ⅱ. Conclusion： The incidence of NHL in elderly patients is higher than others, and the extranodal lymphoma and β-cell lymphoma are more frequent in China.