摘要
目的回顾性分析韦氏环与结内弥漫性大B细胞淋巴瘤的临床特征和预后。方法分析病理确诊的韦氏环和结内弥漫性大B细胞淋巴瘤181例资料，其中韦氏环80例，结内101例。Ann Arbor分期Ⅰ期57例，Ⅱ期83期，Ⅲ期26例，Ⅳ期15例。Ⅰ-Ⅱ期接受化疗加受累野照射，Ⅲ～Ⅳ期以化疗为主。结果与结内弥漫性大B细胞淋巴瘤相比，韦氏环弥漫性大B细胞淋巴瘤多表现为临床Ⅱ期和邻近器官受侵，少见全身症状、脾受侵、乳酸脱氢酶和B2微球蛋白升高。韦氏环和结内弥漫性大B细胞淋巴瘤的5年总生存率分别为76％和56％（X^2=2．43，P=0．119），Ⅰ～Ⅱ期韦氏环和结内弥漫性大B细胞淋巴瘤的5年总生存率分别为78％和58％（X^2=2．76，P=0．097）。单因素分析显示乳酸脱氢酶升高、国际预后指数评分≥1、B2微球蛋白升高是韦氏环弥漫性大B细胞淋巴瘤患者的预后不良因素，而β2微球蛋白升高、大肿块和国际预后指数评分≥1与结内弥漫性大B细胞淋巴瘤患者的预后差有关。多因素分析显示只有乳酸脱氢酶升高、β2微球蛋白值升高与全组患者预后差有关。结论与结内病变相比，韦氏环弥漫性大B细胞淋巴瘤具有某些不同的临床特征。
Objective To analyze clinical characteristics of diffuse large B-cell lymphoma （DL-BCL） of Waldeyer＇s ring（WR-DLBCL） comparing with those of nodal DLBCL（N-DLBCL）. Methods 181 patients consecutively diagnosed as primary WR-DLBCL（80） or N-DLBCL（ 101 ） were retrospectively reviewed. According to Ann Arbor staging system,57,83,26 and 15 patients had stage Ⅰ ,Ⅱ, Ⅲ and Ⅳ disease,respectively. Patients with stage Ⅰ～Ⅱ disease were treated with chemotherapy and radiotherapy, whereas patients with stage Ⅲ～Ⅳ disease received primary chemotherapy. Results Comparing with N-DL-BCL, patients with WR-DLBCL presented with more stage Ⅱ diseases,more frequent involvement of adjacent organs and tissues, less B-symptoms, less involvement of spleen and lower lactate dehydrogenase （LDH） and β2-microglobulin（B2M） level. The 5-year overall survival（OS） rate of all patients was 76% for WR-DLBCL and 56% for N-DLBCL（ X^2 = 2.43,P = 0.119）, respectively. The corresponding OS rate for stage Ⅰ and Ⅱ diseases was 78% for WR-DLBCL and 58% for N-DLBCL（X^2 = 2.76,P = 0.097）, respectively. On univariate analysis, elevated LDH, IPI and elevated 132M were prognostic predictors for WR-DLBCL patients, whereas elevated β2M,bulky tumor and IPI were associated with poor OS for N-DLBCL patients. On multivariate analysis,elevated LDH and β2M were prognostic predictors for all patients. Conclusions Comparing with N-DLBCL,WR-DLBCL represents distinct clinical features and prognosis.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2009年第1期7-10,共4页
Chinese Journal of Radiation Oncology
