34例结外NK/T细胞淋巴瘤鼻型临床分析

Clinical study of 34 patients with extranodal NK/T cell lymphorna-nasal type

目的:探讨结外NK/T细胞淋巴瘤鼻型的临床特征,误诊误治原因及影响愈后的因素。方法:回顾性分析34例结外NK/T细胞淋巴瘤的临床资料,其中ⅠE局限10例,ⅠE超腔15例,ⅡE6例,ⅣE3例;发生于鼻腔29例,鼻腔外5例;行单一放疗或化疗14例,放疗加化疗综合治疗20例。结果:误诊率58.8%(20/34),误治率52.3%(18/34)。5年生存率,ⅠE局限组60.0%(6/10),ⅠE超腔组26.7%(4/15)ⅡE16.7%(1/6),ⅣE0%(0/3),各分期生存率均差异有统计学意义(均P<0.01)。其中ⅠE超腔单一治疗6例。5年生存率0%,ⅠE局限组综合治疗2例,5年生存率50%(1/2)。结论:结外NK/T细胞淋巴瘤鼻型早期临床特征不典型,易误诊误治,确诊依赖病理及免疫组织化学检查。临床分期为影响愈后主要原因,早期诊断和治疗是关键。

Objective：To explore the clinical feature, the reason of misdiagnosis and mistreatment, influential factor of prognosis in patients with exranodal NK/Tcell lymphoma-nasal type. Method： A retrospective study was made on the clinical data of 34 patients with extranodal NK/T cell lymphoma-nasal type. Among them, 10 cases were staged ⅠE intra-cavity,15cases were ⅠE ex-cavity, 6 cases were ⅡE and 3cases were ⅣE. Among them,29 cases were in nasal cavity, 5 cases were outside nasal cavity; 14 cases were treated with single chemotherapy or radiation therapy, 20 cases were treated with radiation therapy add chemotherapy. Result： The total rate of misdiagnosis and mistreatment were 58.8 % （20/34）, 52.3 % （18/34）, respectively. The 5-year survival rate of the ⅠE intra-cavity group were 60.0%（6/10）, and those of ⅠE ex-cavity group wer 26.7%（4/15） ,and those of ⅡE group and ⅣE, group were 16.7%（1/6）, 0%（0/3）, respectively There was significant difference between 3 groups by statistical analysis（ P〈0.01 ）. The 5-year survival rate of ⅠE ex-cavity group treated with single therapy were 0% （0/6） ,and those of ⅠE-cavity group treated with combined therapy were 50% （1/2）. Conclusion： The early clinical manifestation of extranodal NK/T tell lymphoma-nasal type is atypical and which is hard to diagnose and treat. Diagnosis depends on pathologic biopsy and immunohistochemistry, there are many factors that influence the prognosis of this disease, in which the clinical stage is a major factor. It is crucial for diagnosing and treating early.