摘要
目的 探讨老年人EB病毒阳性（EBV＋）弥漫大B细胞淋巴瘤（DLBCL）的临床病理学特点及预后.方法 采用回顾性研究的方法 ,收集24例老年EBV＋DLBCL患者,以同期EBV-非特指型DLBCL患者为对照,分析老年EBV＋ DLBCL患者的临床病理学特点及预后.结果 24例老年EBV＋DLBCL患者肿瘤细胞形态上主要表现为单一性或多形性肿瘤细胞增生;多形性病例中常可见有地图状坏死.细胞起源免疫分型主要为非生发中心亚型,分别占91.3％（Hans分型）和100.0％（Choi分型）.CD30阳性率为55.0％,高于非特指型EBV-DLBCL（P＜ 0.001）.在总体生存时间方面,R-CHOP方案治疗的老年EBV＋DLBCL患者和＞50岁EBV-DLBCL患者的中位生存时间分别为44.2个月和29.2个月,两者差异无统计学意义（P=0.587）.结论 老年人EBV＋DLBCL肿瘤细胞形态上主要表现为单一性或多形性肿瘤性增生;多形性病例中常可见不规则坏死.CD30阳性率较高,并且主要为非生发中心B细胞亚型.R-CHOP方案治疗的老年EBV＋ DLBCL患者的总体生存时间与同年龄段非特指型EBV-DLBCL患者相近.
Objective To analyze the clinical pathological characteristics and prognosis of elderly patients with EB virus-positive diffuse large B-cell lymphoma （EBV＋ DLBCL）.Methods 24 elderly patients with EBV ＋ DLBCL were collected to evaluate their clinical pathological characteristics and prognosis by comparison with the EBV-DLBCL,NOS during the same period.Results 24 EBV ＋ DLBCL cases demonstrated two morphologic subtypes：polymorphic and monomorphic.And polymorphic subtype showed geographic necrosis more frequently than that in monomorphic subtype.According to Hans and Choi models,the majority of EBV＋ DLBCL of the elderly were classified as non-GCB subtype （91.3 ％ and 100.0 ％,respectively）.55.0 ％ cases showed CD30 positive,which was significantly higher than that in EBV-DLBCL group （P ＜ 0.001）.Under the treatment of R-CHOP regimen,the overall survival （OS） of the elderly EBV＋ DLBCL patients showed no significant difference with the ＞50-year old EBV-DLBCL patients （the median OS were 44.2 months and 29.2 months,P =0.587）.Conclusions The elderly EBV ＋ DLBCL patients are normally presented with polymorphic and monomorphic patterns.And geographic necrosis are often seen in polymorphic cases.CD30 expression and non-GCB subtypes are high.With the R-CHOP regimen,the OS of the elderly EBV＋ DLBCL patients is similar with that of ＞50-year old EBV-DLBCL patients.
出处
《白血病．淋巴瘤》
CAS
2014年第4期204-207,212,共5页
Journal of Leukemia & Lymphoma
