摘要
目的 比较原发结外与结内弥漫大B细胞淋巴瘤(DLBCL)患者的临床病理特点及预后方面的差异.方法 回顾分析2007年1月至2012年12月134例DLBCL患者的临床病理特征及治疗疗效.结果 DLBCL 134例,占同期收治非霍奇金淋巴瘤(NHL)的52.14%(134/257),结外DLBCL共93例占总体DLBCL的69.4%.结外DLBCL分期为Ⅲ~Ⅳ期者占55.9%(52/93),结内DLBCL中Ⅲ~Ⅳ期者占75.6%(31/41),差异有统计学意义(P=0.035).结外DLBCL中乳酸脱氢酶升高者占33.3%(31/93),而结内DLBCL中升高者占58.5%(24/41),差异有统计学意义(P=0.008).其他临床特征如出现B症状、大肿块、骨髓浸润、红细胞沉降率升高的比例及美国东部肿瘤协作组(ECOG)评分、国际预后指数(IPI)评分差异均无统计学意义(均P>0.05).结外与结内DLBCL生发中心及非生发中心起源出现的比例差异无统计学意义(P=0.623).结外与结内DLBCL的3年总生存率分别为73.2%、55.2%,3年疾病无进展生存率分别为46.3%、44.1%,差异均无统计学意义(P值分别为0.065、0.748).结论 原发结外DLBCL的发病率较高,与结内DLBCL相比其临床分期较早,肿瘤负荷较低,但两者的免疫表型、分化特征及预后无明显差异.
Objective To evaluate the difference between nodal and extra-nodal diffuse large B-cell lymphoma (DLBCL) in clinical-pathological feature and prognosis.Methods The clinical data of 134 cases of DLBCL patients were reviewed and analyzed.Results The DLBCL patients accounted for 52.14 % (134/257) of non-Hodgkin lymphoma of the same period and the extra-nodal DLBCL patients accounted for 69.4 %.The proportion of stage Ⅲ/Ⅳ disease in extra-nodal DLBCL and nodal DLBCL were 55.9 % (52/93) and 75.6 %(31/41),respectively.Elevated LDH was reported in 33.3 % (31/93) of extra-nodal DLBCL and 58.5 % (24/41)of nodal DLBCL Other clinical characteristics such as B symptoms,bulky disease,elevated ESR,ECOG scores and IPI scores were not significantly different between these two groups (all P > 0.05).No difference in the frequency of GCB and non-GCB subtypes was observed between extra-nodal and nodal DLBCL (P =0.623).The 3-year overall survival rates and 3-year progression free survival rates for extra-nodal and nodal DLBCL were 73.2 %,55.2 % (P =0.065) and 46.3 %,44.1% (P =0.748).Conclusions The morbidity of extranodal DLBCL is high.Primary extra-nodal DLBCL patients present early-stage disease and normal LDH more frequently than the nodal DLBCL,while no significant difference in the frequency of pathological subtypes and 3-year OS and PFS is observed between these two groups.
出处
《白血病.淋巴瘤》
CAS
2014年第4期208-212,共5页
Journal of Leukemia & Lymphoma
基金
吉林省重点科技攻关项目(20130206024SF)
关键词
淋巴瘤
大B细胞
弥漫型
原发部位
临床特点
病理分型
预后
Lymphoma, large B-cell, diffuse
Primary site
Clinical characteristic
Pathological subtype
Prognosis