扁桃体弥漫大B细胞淋巴瘤32例临床分析

Clinical features of 32 diffuse large B-cell lymphoma of the tonsi

目的探讨扁桃体弥漫大B细胞淋巴瘤的临床特点并研究影响其预后的因素。方法通过回顾临床资料,研究我院32例扁桃体弥漫大B细胞淋巴瘤患者的临床特点及治疗效果,Ⅰ期和Ⅱ期患者23例(71.87%)主要接受放化疗联合治疗,Ⅲ期和Ⅳ期9例患者以化疗为主,化疗方案为标准RCHOP或者CHOP,临床跟踪随访,分析影响预后的相关因素。结果含有利妥昔单抗的化疗方案组完全缓解率(CR)高于CHOP组,Ⅰ期和Ⅱ期患者的5年生存率为81.23%,Ⅲ、Ⅳ期患者5年生存率为57.26%。预后分析显示:患者发病年龄、乳酸脱氢酶、分期和预后明显相关。结论扁桃体弥漫大B细胞淋巴瘤大部分处于早期阶段,预后较好。CHOP或RCHOP+放疗的联合治疗可能是治疗早期扁桃体弥漫大B细胞淋巴瘤的标准方案,年龄、乳酸脱氢酶水平、临床分期是影响DLBCL预后的重要因素。

Objective To investigate the clinical features of 32 difuse large B-cell iymphoma of the tonsil and explore the influence factors on the prognosis.Methods The clinical features and effect of treatment of 32 cases of difuse large B-cell lymphoma of the tonsil were analyzed.The influence factors on the prognosis were explored.23（71.87%）patients with Stage Ⅰ-Ⅱ received diochemotherapy-predominant treatment,whereas patients with stage Ⅲ-Ⅳ received chemotherapy-predominant treatment.The combined chemotherapy included of CHOP or RCHOP.Results Rituximab can increase the therapeutic efficacy of CHOP regimen on diagnosed patients with difuse large B-cell lymphoma of the tonsil.The 5 years survival rate of stage Ⅰ-Ⅱ patients was 81.23% and stage Ⅲ,Ⅳ patients was 57.26%.The prognosis analysis showed that the prognosis had association with the age,stage and LDH level.Conclusion Most patients with difuse large B-cell lymphoma of the tonsil are at early stages with good prognosis;RCHOP regimen combined with radiotherapy may be a proper treatment;Age,stage and LDH level are the important factors which affect on diffuse large B-cell lymphoma prognosis.