62例霍奇金淋巴瘤患者临床特征与预后分析

Clinical characteristics and prognostic factors of 62 cases with Hodgkin lymphoma

目的探讨霍奇金淋巴瘤（HL）的一般临床特征、病理分型和预后相关因素。方法收集62例HL患者临床资料，其中45例患者资料来源于北京大学第三医院，17例患者资料来源于山西大医院。对其临床特征、治疗及预后相关因素进行回顾性分析。结果北京大学第三医院的资料显示HL患者占同期新发淋巴瘤患者总数的5．66％（795例患者中45例）。62例患者中男女比例为2．1：1，病理类型以结节硬化型（53．23％）和？昆合细胞型（30．6％）为主。可随访病例56例，中位随访时间45（8～184）个月，治疗总有效率92．9％，2、3、5年总体生存（OS）率分别为97．7％、92．2％、80．5％。单因素预后分析结果显示，脾脏累及（P=0．042）和德国霍奇金淋巴瘤研究组（GHSG）评分系统分值（P=0．002）对患者OS率的影响差异有统计学意义。结论HL为一种可治愈的恶性肿瘤，患者5年OS率为80．5％，复发后部分患者病程呈惰性，对于二线方案治疗仍有较高的缓解率。GHSG评分系统对HL的预后有较好的预测价值，脾脏累及可作为HL患者的预后因素。

Objective To investigate the clinical characteristics, pathologic types and prognostic factors of Hodgkin lymphoma （HL）. Methods Retrospective analyses of clinical data of 62 HL patients, including 45 from Peking University third hospital and 17 from Shanxi Dayi hospital. Results Sixty-two HL patients accounted for 5.66% of the total newly diagnosed patients with lymphoma （45/795） in the period with a ratio of male： female as 2.1 ： 1. All the pathological types were classical Hodgkin lymphoma （cHL）, including 33 cases （53.2%） of nodular sclerosis type （NS） and 19 cases （30.6%） of mixed cell type （MC）. Of the 56 cases followed up, the total responsive rate was 92.9%, and 2-, 3- and 5-year overall survival （OS） rates were 97.7%, 92.2% and 80.5% respectively with the median OS as 45 （8-184） months. Analyses of the prognostic factors indicated that the involvement of spleen（P=0.042） and German Hodgkin Study Group（GHSG） risk score （P=0.002） were poor factors with statistic significance. Conclusion HL is one of the curable malignant tumors, 5-year OS rate was 80.5% in this group. After recurrence, part of patients developed slowly and could be salvaged with second-line therapy with high remission rate. GHSG scoring system and involvement of spleen could predict the prognosis in HL setting.