22例原发腮腺非霍奇金淋巴瘤临床分析

Primary non -Hodgkin＇s lymphoma of the parotid gland

目的探讨原发腮腺非霍奇金淋巴瘤（PLP）的临床、病理特点以及合理的治疗方法。方法回顾性分析22例PLP。根据AnnArbor分期，IEA期12例，ⅡEA期10例。根据WHO淋巴肿瘤病理分类，黏膜相关淋巴组织淋巴瘤（MALTL）9例，弥漫大B细胞淋巴瘤（DLBCL）10例，1、2级滤泡淋巴瘤（FL）3例。有2例MALTL患者有干燥综合征病史。8例MALTL和FL在术后接受单纯放疗，仅3例术后接受化放综合治疗。8例DLBCL在术后接受化放综合治疗。结果全组首程治疗后复发5例，无放疗野内复发，其中9例MALTL中1例复发，10例DLBCL中3例复发。全组5年总生存率和无病生存率分别为89％和73％。MALTL和DLBCL患者的5年总生存率分别为100％和80％（P=0．160），5年无病生存率分别为90％和59％（P=0．090）。结论腮腺是MALTL易于发生的部位，尤其是伴有干燥综合征的患者；早期腮腺MALTL采用单纯放疗，早期DLBCL采用化放综合治疗后可获得良好的疗效。

Objective To analyze the clinicopathological characteristics and treatment of primary non-Hedgkin＇s lymphoma of the parotid gland （PLP）. Methods From July 1995 to December 2005, twenty -two patients with PLP treated in our hospital were retrospectively analyzed. According to Ann Arbor stages, there were 12 ⅠEA and 10 ⅡEA. Based on WHO histological classification, 9 patients had mucosa - associated lymphoid tissue lymphoma （MALTL）, 10 diffuse large B cell lymphoma （DLBCL） and 3 Grade Ⅰ and Ⅱ follicular lymphoma （FL）. Two of 9 MALTL patients had a previous history of Sjoegren syndrome. Eight of MALTL and FL patients received radiotherapy alone and 8 of DLBCL patients were treated with a combination of radiotherapy and chemotherapy. Results With a median follow -up of 61 months, one patient with MALTL and 3 patients with DLBCL developed recurrences outside the irradiated field. The 5 -year overall survival （OS） and disease free survival （DFS） were 89% and 73% , respectively. The 5 -year OS and DFS were 100% and 90% for patients with MALTL as compared to 80% and 59% for those with DL- BCL. Condusions MALTL can be present as a primary non -Hedgkin＇s lymphoma of the parotid gland, especially in patients with Sjoegren syndrome. Radiotherapy should be the lust choice for patients with early stage MALTL, whereas combined medality therapy should be given to patients with DLBCL.