卵巢原发淋巴瘤的临床病理特征及相关文献复习

Clinical analysis of 16 cases with primary ovarian lymphoma and review of literatures

目的:探讨卵巢原发淋巴瘤的临床病理特征、诊断、治疗及预后,并对相关文献进行复习。方法:回顾性分析两家医院16例卵巢原发淋巴瘤的临床资料及治疗情况。结果:16例患者中位年龄29.5岁,病理诊断以弥漫大B细胞性淋巴瘤为主。按Ann Abor分期,81.3%为Ⅰ～Ⅱ期;按FIGO分期,62.5%为Ⅲ～Ⅳ期。100%的患者外周血CA125升高,有效治疗后下降,复发时升高。以手术为主的综合治疗效果较单一手段好。联合化疗CHOP方案有一定的疗效,完全缓解率68.8%,复发率54.5%,死亡率37.5%。中位随访时间为39.7月,5年无疾病生存率(DFS)为40.0%,5年总生存率(OS)为62.5%。结论:CA125可作为卵巢淋巴瘤肿瘤负荷、疗效观察、预测复发、预后等方面的指标;FIGO分期在卵巢淋巴瘤中有一定的应用价值;卵巢淋巴瘤治疗应采用以手术和化疗为主的综合治疗。

Objective：The purpose of this study is to investigate the clinical and pathological features, and the optimal treatment approach for primary ovarian non-Hodgkin＇s lymphoma （POL） patients. Methods：From 1986 to 2006, 16 patients who were diagnosed with POL and received treatment in our hospital were included. Results：Of the 16 patients, the age ranged from 6-56 years old with a median age of 29. 5 years old. Most of the pathology diagnosis was diffused large B-cell lymphoma subtype. According to the Ann Arbor staging system, 81.3% of the patients were stage Ⅰ - Ⅱ ; However, 62.5% of the patients were stage Ⅲ-Ⅳ according to FIGO staging system for ovarian carcinoma. The serum CA125 level was increased significantly at the initial diagnosis, but decreased to the normal level after induction chemotherapy. The combination treatment based on operation was a prognosis factor for POL patients. The efficacy of CHOP regimen varies according to different pathology subtypes. For all the 16 patients, the complete remission （CR） rate of was 68. 8%. With a median follow-up time of 39. 7 months, the relapsed rate and death rate was 54. 5% and 37.5%, respectively. The 5 year overall survival and disease free survival was 40% and 62. 5%, respectively. Conclusion：The serum CA125 level was an indication of tumor burden, providing the evidence of efficacy chemotherapy and good prognosis. FIGO classification was found to be a prediction of the prognosis. The optimal treatment was radical surgery operation followed by combination chemotherapy.