原发性鼻腔非霍奇金淋巴瘤免疫表型及临床分期与预后的关系

Relationship between immunophenotype and clinical stage and prognosis in primary non-hodgkin's lymphoma of nasal cavity

目的探讨原发性鼻腔非霍奇金淋巴瘤(NHL)免疫表型及临床分期与预后的关系。方法研究对象为随机入选的1998年1月至2002年12月在复旦大学附属眼耳鼻喉科医院进行活检并诊治的原发性鼻腔NHL患者54例,通过单因素和多因素方法回顾性分析免疫表型、临床分期等因素对其预后的影响。结果全部患者的5年总生存率为54.60%,其中NK/T和T细胞淋巴瘤的5年生存率分别为35.00%和62.30%,在全组患者和ⅠE期患者中,根据不同的免疫表型作生存分析显示NK/T细胞淋巴瘤预后较T细胞淋巴瘤差(P值分别为0.048和0.047)。在临床ⅠE期病例中,病变局限于鼻腔组的预后优于病变超越鼻腔组(P=0.031),其5年生存率分别为70.70%和40.00%。结论单因素和多因素分析结果表明原发性鼻腔NHL的免疫表型和临床分期是重要的预后因素。

Objective To investigate the relationship between immunophenotype and clinical stage and prognosis in primary non-Hodgkin＇s lymphoma（NHL） of nasal cavity. Methods Records of 54 patients with NHL of nasal cavity selected randomly, treated from Jan. 1998 to Dec. 2002 in Eye ENT Hospital of Fudan University, were retrospectively analyzed by univariate and multivariate analysis in immunophenotype, clinical stage, etc. Results The 5-year overall survival rate for all patients was 54. 60%. The 5-year survival rates were 35.00% for NK/T-cell lymphoma, and 62. 30% for T-cell lymphoma. Of the three subtypes of primary lymphomas of nasal cavity, NK/T-cell lymphomas seemed to carry worse prognosis than T-cell lymphomas, the significance probabilities were 0. 048 （ log- rank） for all patients,0. 047 （log-rank）for patients in stage I E respectively. Of the stage I E primary NHL of nasal cavity,tymphomas of lesions limited to the nasal cavity had better prognosis than that of lesions extending to structures out of the nasal cavity （ P = 0. 031, log-rank）, and the 5-year survival rates were 70.70% and 40. 00% respectively. Conclusions Our data indicate that by univariate analysis and multivariate analysis immunophenotype and clinical stage are identified as the important prognostic factors in primary NHL of nasal cavity.