原发性腮腺淋巴瘤24例临床资料及预后分析

Analysis of clinical data and prognosis for 24 patients with primary parotid malignant lymphoma

目的探讨原发性腮腺恶性淋巴瘤的临床、病理特点及治疗、预后。方法回顾性分析24例原发性腮腺淋巴瘤患者的病理类型、分期、治疗，应用Kaplan—Meier法行生存分析和Log—Rank检验法行差异显著性检验。结果全组5年无进展生存率为79．2％、总生存率为83．3％；19例黏膜相关淋巴组织淋巴瘤（MALTL）和Ⅰ、Ⅱ级滤泡型淋巴瘤（FL）的5年无进展生存率为89．5％、总生存率为94．7％，其中接受化疗（9例）与未接受化疗（10例）的两组患者的5年无进展生存率（88．9％与90．0％）和总生存率（100％与90．0％）比较差异均无统计学意义。结论腮腺淋巴瘤发病率低，分期一般为早期，病理类型多为低度恶性B细胞型非霍奇金淋巴瘤，总体预后较好。早期低度恶性患者可单纯行手术和（或）放疗的局部治疗，而对于侵袭性弥漫性大B细胞淋巴瘤（DLBCL），化放疗联合的综合治疗可能是最佳选择。

Objective To discuss the clinical and pathological characteristics, treatment results and prognosis of primary parotid malignant lymphoma. Methods Pathological subtypes, clinical stages and treatment of the 24 patients with primary parotid malignant lymphoma were retrospectively analysed. Kaplan- Meier method was used in the survival analysis and Log-Rank method was used in the statistic study. Results The 5-year progression free survival （PFS） and overall survival （OS） were 79.2 % and 83.3 %, respectively. The 5-year PFS and OS were 89.5 % and 94.7 % for 19 patients with low-grade malignant lymphoma （including MALTL and Ⅰ /Ⅱ grade FL）. The differences of the 5-year PFS and OS of 9 patients received chemotherapy and of 10 patients with on chemotherapy had no statistical significance. Conclusion The incidence of primary parotid malignant lymphoma is low, at earlier clinical stage, and most of its pathological subtype were B-cell low-grade malignant non-Hodgkin lymphoma. Surgery and/or radiotherapy should be the first choice for patients with early stage low-grade malignant lymphoma, whereas combined modality therapy was probably the best choice for patients with DLBCL.