21例原发乳腺淋巴瘤临床分析并文献复习

Primary breast lymphoma-A report of 21 cases with literature review

目的:探讨原发乳腺淋巴瘤(primary breast lymphoma,PBL)的临床、病理特点、诊断、治疗方法及预后。方法:回顾性分析中山大学附属肿瘤医院1998年至2015年收治的21例PBL住院患者一般病例资料、分析其疾病特征、治疗及预后等情况。结果:21例中患者均为女性,年龄13~78岁,中位年龄41岁。ⅠE期12例、ⅡE期4例、ⅣE期5例,病理类型以弥漫大B细胞淋巴瘤为主(17/21例),治疗及预后:全组患者9例(42.9%)接受联合化放疗,11例(52.4%)单纯化疗,化疗方案以CHOP(7例)和RCHOP(11例)为主。中位随访42个月(3~126月),全组中位生存期56月,3年总生存率为84%,5年总生存率为78%。化疗联合靶向与单纯化疗相比、化疗联合放疗与单纯化疗相比,5年总生存率均无显著差异(88.2%和76.5%,P=0.77;84.3%和72.6%,P=0.38)。结论:PBL接受以化疗为主的治疗,总体预后较好。

Objective： To investigate the clinical and pathological characteristics,diagnosis,treatment and prognosis of primary breast lymphoma（ PBL）. Methods： Clinical records of 21 PBL patients diagnosed between 1998 and2015 in Sun-Yatsen university cancer center were retrospectively analyzed. Results： The patients were all female,aged between 13 to 78 years,with the median age of 41 years old. 12 patients had IE disease,4 patients had IIE disease and 5 had IVE disease. 17/21 had diffuse large B cell lymphoma（ DLBCL）. Nine patients（ 42. 9%） received chemotherapy and radiation,and 11（ 52. 4%） received chemotherapy. Chemotherapy regimens mainly consisted of CHOP（ n = 7） and R-CHOP（ n = 11）. Median follow-up duration was 42 months（ ranged from 3 to 126 months）.Median survival time was 56 months. The 3-year survival rate was 84% and the 5-year survival rate was 78%.Compared with chemotherapy,chemotherapy plus targeted therapy and chemotherapy plus radiation did not have statistical difference in 5-year survival rate（ 88. 2% versus 76. 5%,P = 0. 77 and 84. 3% versus 72. 6%,P = 0. 38,respectively）. Conclusion： Patients with PBL had good response to chemotherapy,and the prognosis were generally optimal.