112例化疗有效的非霍奇金淋巴瘤的临床病理特征及预后分析

An analysis of the clinicopathologic features and prognosis of 112 cases of non-Hodgkin's lymphoma with effective chemotherapy

目的:研究化疗有效的非霍奇金淋巴瘤(NHL)的临床病理特征,探讨其预后和治疗。方法:回顾性分析112例经初治或经复治获得完全缓解的NHL的临床病理特点、化疗方式以及随访结果。结果:(1)112例NHL中,B系占76.8%(86/112),以弥漫大B细胞淋巴瘤(DLBCL)最常见,占40.2%(45/112);NK/T系占23.2%(26/112),以非特殊性外周T细胞性淋巴瘤(PTCL)最常见,占12.5%(14/112)。(2)复治病例获得完全缓解时平均化疗周期数为9个,显著多于初治病例(平均化疗周期数为4个)(P<0.05)。(3)套细胞性淋巴瘤(MCL)和B淋巴母细胞性淋巴瘤(B-LBL)复治例数比例分别为57.1%(4/7)和66.7%(2/3),获得CR时化疗周期数均为12个,显著多于其他组织类型(P<0.05)。(4)本组112例患者均随访3年以上,其中82例随访5年以上,3年和5年生存率分别为50.0%(56/112)和35.4%(29/82)。生存率主要与年龄、B症状、临床分期、LDH水平以及复发情况有关(P<0.05),而与性别和发生部位无关(P>0.05)。结论:NHL具有明显的异质性,应根据患者各自的临床病理特征及组织学类型综合考虑治疗计划,制定适宜的化疗方案。

Objective：To explore the clinicopathologic features of non-Hodgkin＇s lymphoma（NHL）in Chinese people and discuss the relationship between clinical data and the prognostic factors.Methods：The clinical data of 112 cases of NHL including 95 cases of previous untreated patients and 17 cases of retreated patients were analyzed retrospectively.Results：Of the 112 cases studied,86 cases（76.8%）were of B-cell lineage and 26 cases（23.2%）were of NK or T-cell lineage.As for the subtype of B-NHL,diffuse large B cell lymphoma was the commonest（40.2%）,While as for the subtype of NK/T-NHL,Peripheral T-cell lymphoma,unspecified was the commonest（12.5%）.The mean cycles of chemotherapy of the retreated patients was nine when being complete remission,which was significantly more than the previous untreated patients（the latter was four cycles）（P〈0.05）.The ratios of the retreated patients of mantle cell lymphoma（MCL）and B-lymphoblastic cell lymphoma（B-LBL）were 57.1%（4/7）and 66.7%（2/3）respectively,which was significantly more than other subtypes（P〈0.05）,and the mean cycles of chemotherapy of the both were 12 when being complete remission,also was significantly more than other subtypes（P〈0.05）.All the patients were followed up more than 3 years,among them 85 patients were followed up to 5 years,the 3-year and 5-year survival rates were 50.0%（56/112）and 35.4%（29/82）,respectively.The data showed that age（≥60 or〈60）,B symptoms,clinical stage,serum lactate dehydrogenase（LDH）level and recurrence were closely associated with survival（P〈0.05）,while gender and tumor site were not associated with survival（P〉0.05）.Conclusion：Non-Hodgkin＇s lymphoma was a panel of heterogeneous tumor,the appropriate protocols of chemotherapy should be given by combinations of clinicopathologic features and tissues subtypes.