摘要
目的为了提高对妇科恶性肿瘤鉴别诊断的能力,回顾性分析6例以妇科肿瘤为临床表现的非霍奇金淋巴瘤的临床和病理特点,了解诊断和治疗方法,预后因素。方法收集2008年至2016年在妇科诊治的6例非霍奇金淋巴瘤临床资料。结果平均发病年龄57.8岁。主要临床表现为盆腔肿物、腹痛和阴道排液;5/6例伴有血清CA125升高,4/6例有血清LDH升高。4例接受开腹手术,手术探查证实肿瘤来自回肠1例,来自卵巢1例,来自结肠系膜1例,以及来自直肠与子宫宫颈卵巢融合的大肿瘤1例。另外2例接受了宫颈活检和阴道肿瘤活检。病理诊断,6例患者均为NHL弥漫大B细胞淋巴瘤。免疫组化染色对CD20(+),CD3(-),ki67(+)60%~90%。6例患者接受了以R-CHOP方案为主的化疗,4-10疗程。除1例死亡以外,5例达到完全缓解和部分缓解。平均生存50个月(4~112个月),其中3例无瘤生存5年以上。结论对于表现为妇科恶性肿瘤的病人实施肿瘤切除或者活检,是获得病理诊断的重要方法。R-CHOP方案是治疗结外NHL DLBCL的有效方法。
Objective To improve the ability of differential diagnosis of gynecologic malignancy,analyze the clinicopathology dates of 6 cases Non-Hodgkin lymphoma(NHL),with the clinical manifestations as gynecologic malignancy.Methods The medical records of 6 patients with diagnosis non-Hodgkin lymphoma of the pelvic masses from 2008 to 2016 at Peking University People's Hospital were reviewed respectively.Results The mean age of 6 patients at presentation was 57.8 years(range 50 to 66 years).The main clinical manifestations were pelvic mass,lower abdominal pain and vaginal discharge.Serum CA125 was elevated at 5/6 patients and serum LDH increased at 4/6 patients.4 cases underwent laparotomy,the surgical exploration confirmed that the tumors derived from ileum,right ovary,mesocolon and a big rectum tumor fused with uterus cervix and ovary,respectively.The other 2 patients received tumor biopsy on cervix and vagina respectively.Pathological diagnosis of all patients were Primary extranodal NHL with subtype of diffuse large B cell lymphoma(DLBCL).The immunohistochemisty on all tumors presented as CD20(+),CD3(-),ki67(+)60% ~ 90%.Combination chemotherapy with R-CHOP regime was used in all patients.The overall median survival from the diagnosis of NHL was 50 months(4 ~ 112 months),with 1 case died because of disease and 3 cases living more than 5-year.Conclusion Gynecologic surgery or biopsy on the suspicious pelvic malignancy was the way to obtain the pathologic diagnosis.Combination Chemotherapy is the efficient therapy to treat on the patients with NHL.
出处
《中国妇产科临床杂志》
CSCD
北大核心
2018年第1期23-26,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
北京大学人民医院研究与发展基金(RDE2016-07)
关键词
非霍奇金淋巴瘤
弥漫大B细胞淋巴瘤
妇科恶性肿瘤
化疗
Non-Hodgkin's lymphoma, diffused large B-cell lymphoma, gynecological neoplasia, Chemotherapy