Burkitt淋巴瘤69例临床特点分析

Clinical Analysis of 69 Cases of Burkitt’s Lymphoma

背景与目的:Burkitt淋巴瘤(Burkitt Pslymphoma)是高度恶性B细胞性非霍奇金淋巴瘤,非洲流行区的临床特点与美国、欧洲等散发区的临床特点不同,而中国尚未见此型淋巴瘤的大宗临床总结。本文中对中国Burkitt淋巴瘤临床特点进行分析总结。方法:回顾性分析中山大学肿瘤防治中心1985年5月至2007年5月收治的69例病理确诊为Burkitt淋巴瘤病例的临床特点。结果:69例患者中,男性44例,女性25例;年龄2～72岁,中位年龄7岁;Ⅰ期5例,Ⅱ期9例,Ⅲ期21例,Ⅳ期34例,晚期(Ⅲ期和Ⅳ期)病例占79.7%。颈部淋巴结(68.1%)、腹部(63.8%)和颌面口咽(34.8%)为最常见的侵犯部位,可伴有骨髓(21.9%)和中枢侵犯(17.4%)。有B症状者占50.7%。42/58(72.4%)血清LDH水平升高,13/56(23.2%)血清尿酸升高。6/57存在HBV感染,7/13存在EBV感染,0/51存在HIV感染。采用短疗程、高强度化疗联合中枢预防,疗效较好,患者生存有较明显的改善。结论:本研究收集的69例Burkitt淋巴瘤与散发区的病例临床特点较为接近,但中位发病年龄较低;肿瘤侵犯部位介于流行区和散发区之间,以颈淋巴结、腹部和颌面口咽为主。

BACKGROUND ＆ OBJECTIVE： Burkitt＇s lymphoma is a kind of highly aggressive B-cell lymphoma. Its clinical characteristics are different between the endemic areas in Africa and the sporadic areas in America and Europe. There is no large-scale report concerning Burkitt＇s lymphoma in China yet. This study was to summarize the characteristics of Burkitt＇s lymphoma in China. METHODS： Clinical data of 69 Burkitt＇s lymphoma patients, treated from May 1985 to May 2007 in Cancer Center of Sun Yat-sen University, were analyzed. RESULTS： Of the 69 patients, 44 were men and 25 were women, with a median age of 7 （range, 2-72） ; 5 were at stage Ⅰ , 9 at stage Ⅱ , 21 at stage Ⅲ, and 34 at stage Ⅳ, advanced stage （stages Ⅲ and Ⅳ） accounted for 55 （79.7%） patients. Abdomen （63.8%）, cervical lymph nodes （68.1%） and faciomaxillary-oropharynx （34.8%） were the most common involved sites. Bone marrow （21.9%） and central nervous system （17.4%） could also be involved. B symptoms were found in 34 patients. Serum lactate dehydrogenase （LDH） level was elevated in 42 of 58 patients, while serum uric acid level was elevated in 13 of 56 patients. Hepatitis B virus （HBV） infection was found in 6 of 57 patients, Epstain-Barr virus （EBV） infection in 7 of 13 patients, human immunodeficiency virus （HIV） infection in 0 of 51 patients. Short-term and high intensive chemotherapy with central nervous system prophylaxis could improve the prognosis. CONCLUSION. The clinical characteristics of these 69 Burkitt＇s lymphoma patients are much similar to those from sporadic areas, but the median age is lower, and the most common involved sites are cervical lymph nodes, abdomen and faciomaxillary-oropharynx.